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Andy Roark DVM MS

An Honest Look at What We’re Thankful For

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I’ve seen more than a few shocked faces as I, the guy known for holding the torch of positivity in veterinary medicine, tell people that “life is suffering.” If you’ve listened to my podcasts or read my articles, you’ve heard me tell people that medicine (and management) is simply picking your poison over and over again. One of my favorite quotes centers on the idea that no one, and I mean no one, can escape pain, uncertainty, and hard work. Not exactly the mantra that people expect from the smiling, laughing guy who loves his job.

I think that there is a perception that being positive (or grateful) is about fooling yourself. It’s about refusing to see challenges and hardships, or at least to discount the impact these difficulties have on us. I do think there is power in “choosing happy” and I reject the idea that looking on the bright side always constitutes “toxic positivity.” That idea is simply a cudgel the cynical like to wield against the optimistic.

The healthiest view of the world I have found is a balance between optimism and a pragmatic, honest look at the challenges we are destined to face in this life.

Pretending that hardship isn’t all around us or that the world is fair doesn’t make much sense. Neither does wallowing in the knowledge that we have very limited control over much of our lives and death comes for us all. A balance between these mindsets, however, can be a thing of beauty.

As I reflect on what I’m thankful for this holiday season, my list looks different than it has in the past. Yes, I’m thankful for my family and interpersonal relationships, and I’m optimistic about my chances of deepening and strengthening those bonds in the coming year. I’m thankful for our profession and to have work that I find meaningful and rewarding. I think veterinary medicine has a bright future, and I’m genuinely excited to see where it is going.

At the same time, my list is balanced by a more clear-eyed perspective on how fragile life can be, and a knowledge that hardships inevitably await us all on the road ahead. I’m grateful that my family is healthy. That gratitude is deepened, not diminished, by the fact that one year ago my wife was beginning radiation therapy for breast cancer. I am proud of what my business has done and is doing, and that pride is stronger because we have faced setbacks, suffered failures, and navigated uncertainty. I cherish the laughter around me, because I have seen a lot of tears.

Today, I am more grateful for what I have than ever before. It’s a deep, rich gratitude that I think comes not from blocking out everything but the positive, but by truly seeing the difficulties, learning to accept them, and then looking towards the future with an intentional and dedicated optimism.

My wife is healthy. My children are safe. My job is rewarding. My business is a success in the ways that truly matter. I feel thankfulness for these truths in my bones because I know they are not guaranteed.

What are you thankful for?

Building Your Personal Board of Directors

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Dr. Addie Reinhard joins Dr. Andy Roark on the podcast to delve into the pivotal topic of mentorship in the veterinary field. They explore the significance of crafting a personal board of mentors, offering insights on being an effective mentee and navigating the terrain of feedback. Tune in as they unravel strategies for identifying the ideal mentors and uncover best practices in fostering these invaluable professional relationships.

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

LINKS

Mentorvet.com

MentorVet Facebook and Instagram

MentorVet LinkedIn

Dr. Andy Roark Resources 

Dr. Andy Roark Webinars

Dr. Andy Roark Swag

ABOUT OUR GUEST

Dr. Addie Reinhard is a veterinary wellbeing researcher. Her research focuses on developing and evaluating innovative interventions to support mental health and wellbeing within the veterinary profession. She is the Founder and CEO of MentorVet, an evidence-based mentorship and professional development program for recent veterinary graduates. She is on the research team for the next phase of the Merck Animal Health Veterinary Wellbeing Study. In 2021, she completed a master’s degree in Community and Leadership Development and a Graduate Certificate in College Teaching and Learning from the University of Kentucky and holds a certificate in Veterinary Human Support from the University of Tennessee. She is also a certified QPR instructor.

EPISODE TRANSCRIPT

Dr. Andy Roark:
Welcome everybody to the Cone of Shame Veterinary podcast. I’m your host, Dr. Andy Roark. I got a great one today. I am here with my good friend, Dr. Addie Reinhard. She is amazing. If you’re not familiar with her, her work with MentorVet, you’re in for a real treat. Addie and I have, we’ve become good friends in the last year. She’s just a absolutely wonderful person, one of my favorite people to spend time with. I got so much out of this conversation with her. She’s got so much insight into mentorship and into building relationships. And guys, I genuinely think that the interpersonal relationships we have are probably the most important thing when we decide whether or not we are happy with our life. I really think that those relationships, they matter more than anything as far as satisfaction. I can tell you from personal experience, I don’t think there’s anything that matters more in our careers and getting doors open for us to go and do things, to grow, to learn, to try new things than the people that we know who are willing to give us opportunities and to help us out and to give us advice, and to invest some time into us.
And I just believe that deeply. And so Addie is just such a wonderful person to talk to and she’s got so much information to share. So anyway, I hope you guys will enjoy this episode. I think it’s a great one. 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, Dr. Addie Reinhard. How are you?

Dr. Addie Reinhard:
Hey, doing well. How are you?

Dr. Andy Roark:
Doing great. Thanks for being here. I always love to visit with you.

Dr. Addie Reinhard:
Yeah, it’s always a good time. Lots of laughs usually.

Dr. Andy Roark:
Yeah, usually. For those who don’t know you, you are a veterinarian. You are the founder and CEO of MentorVet. And so MentorVet, actually I’ll let you take it. Why don’t you quickly lay down what MentorVet does?

Dr. Addie Reinhard:
Yeah, so I practiced small animal for about four years, got burnt out a few times, had some great mentors to help me through that. And really recognized how powerful good mentorship and support is really at all stages of your career, but particularly for me in the transition to practice. And so really fell to calling to be able to want to give back to others through creating structures for mentorship. So founded MentorVet, the entity, after spending two years at University of Kentucky doing some research on veterinary wellbeing and more importantly, what can we do about it. So at MentorVet, we create evidence-based programming to support the individuals in the veterinary profession to give them the skills and tools and support structure that they need to help themselves and help others in the field with the ultimate goal of creating a healthier profession for everybody involved.
I love it. You are amazing. I love the work that you do. I really enjoy getting to hang out with you. You and I got to visit in Austin, Texas at the NAVC Hive event, and we basically spent three days together, just so fun talking about the world and eating a lot of brisket and tacos. We had a lot of brisket and tacos. Alright, I want to talk to you. So I want to talk to you. I have a mentorship sort of idea theme that I’m playing around with. I was talking to a very smart veterinarian just like a week or two ago, and she is high up in one of the big vet clinic hospital organizations. And so one of the corporate groups, and she was talking to me about what she thinks the key to success for doctor leaders is. And she said, you need to build your board and build your bench.
And so build your board and build your bench. And so building your board is what you call our, I mean how do you call it a reverse? It’s not reverse mentorship, but it’s basically seeking out mentors, your own professional development mentors. And then your bench is basically developing people around you and being the mentor for others. And I thought that that was really interesting. I just like that phrasing of build your board, build your bench. And so I wanted to talk to you a bit about the building your board part. I know I could talk to you all day about building your bench and you obviously have so much experience mentoring young doctors and things like that. But I want to talk more about this as a later career veterinarian, what mentorship looks like and why more people don’t seem to prioritize it. So lemme just pause here for a second and say, when I talk to you about later career veterinarians, people who have been a vet for at least five years, maybe 10 plus years, do you think those people have a focus on mentorship? Do you think that, I know we’re speaking in broad terms, do they seek out mentorship or is there a general consensus I’m kind of perceiving, which is I’m too old to be mentored. Mentorship is sort of for younger people. What do you think?
Yeah, I think there is a common belief that mentorship is usually reserved for early career individuals, but I think it should be for everyone. And it’s funny you say that because when I ask this question to groups and audiences when I ask who here has a mentor? And usually less than a quarter of people or maybe a third of people raise their hand. So I think we are not leveraging mentorship. We could be, and I think mentorship can be very powerful and it’s how I’ve gotten to where I am in what I’m doing with mentor ed. I wouldn’t be here without all the mentors along the way believing in me when I didn’t even believe in myself and opening doors for me and supporting the work that I do and making me think differently about the world and the things that we were doing and challenging my beliefs on things and getting me to expand my horizons on things. So I think that mentorship is appropriate for all career stages, especially mid-career vets. And I would agree that I don’t think it’s being used nearly as much as it could be.

Dr. Andy Roark:
Wait, so just to be clear, you’re saying a quarter to a third of veterinarians raise their hand saying they have a mentor like one and that’s all that there is really? That’s staggering to me.

Dr. Addie Reinhard:
It’s sad and I don’t know, I think

Dr. Andy Roark:
I’ve got five mentors, I have mentors, people have pairs of shoes, I’ve

Dr. Addie Reinhard:
Got too many, maybe I’m going to have to get rid of one.

Dr. Andy Roark:
Exactly right. I’m sorry Andy

Dr. Addie Reinhard:
Going to have to get you as a mentor.

Dr. Andy Roark:
The tribe has spoken and you put my torch out and then I have to leave the Addie Reinhard mentor party.

Dr. Addie Reinhard:
But yeah, I mean it’s surprising to me because I do have, and I look at mentorship, so mentorship can be a few different things. It can be something where you’re getting support with medical decisions, but professional development has been such an important aspect of my own mentorship and being able to talk with people who both have walked the route you’re walking or are currently walking the route that you are walking can be so helpful to get through the day.

Dr. Andy Roark:
Oh no, no doubt. I mean you were one of my mentors, and I’ll just say this and people don’t think, but I mean people can’t see us. I am markedly older than you were one of my, I called you when I was laying face down trying to make a conference happen that refused to actually happen. And I was like, I don’t know where to go from here. And so I called you because I knew that you have experience in these types of things and the events and running teams and I was just like, I need someone who is not as emotionally invested in this as I am to just look at this for me please and tell me what I’m missing. And it is hugely helpful, but I think that whole, it goes one direction of the older to the younger, I think that that’s such a mistake.
It’s just it’s not true. So I don’t know, how did you get started? I don’t know if you want to tell a story of mentorship opening doors for you as said as you got going, how did this make a difference for you? How did you decide that this mentorship building, this personal board of directors was worth your time? Because I got to tell you, honestly, I don’t know, it’s hard for me to think of anybody that is as good as you are at making people want to support them. Well, but you draw people’s sweet, is it? I don’t know, it’s like, I dunno anyone who just tricks other people into,

Dr. Addie Reinhard:
I dunno, anyone who needs so much.

Dr. Andy Roark:
Exactly. You suck resources from so many people. It’s amazing. How do you do it? How do you do

Dr. Addie Reinhard:
It? How do you do it? How do you get people to help you? So there’s a few things that I think as a mentee and having the mindset that there’s always something to learn from somebody, there’s always something to learn from anybody. And going through life with that mindset and being very curious about what you can learn opens a lot of doors for good connection. Because if you enter in with humility and knowing that I don’t know all the answers. I don’t know all the answers, and being willing to be taught, be teachable. And I think so many times if we’re stuck in, I think especially in my early career, I think about the way that I learned things in school. And if I had come into practice and said, Nope, I’m not going to do it that way. This is how I learned in school, then those people are going to have a harder time mentoring me versus if I’m willing to learn, okay, you’ve been in practice for 20, 30 years, tell me why are you doing it this way?
Oh, okay, well I learned it this way. I don’t know if this is better or worse or just different, but let’s compare notes and see and maybe I can learn a few things from you and maybe you can learn a few things from me. So I think being teachable is one. I would say being proactive is the other. So many people are not proactive about mentorship. So proactive about developing your connections, developing your taking time to chat with people, just making time in your day to reach out and say, Hey, I’ve got a question. Or Hey, can I bounce some things off of you? And the proactivity and actually taking the effort to set up intentional time to talk to somebody about challenges that you’re facing makes them want to help you because they see that you’re making an effort. So being teachable, being proactive and entering in with that mindset of always learning and growing. I’m trying to think of other things that I do. Awesome, but

Dr. Andy Roark:
Well no, I want to start to unpack some of this stuff, right, because I don’t know that people know necessarily what you mean when you say you need to be teachable. But I will tell you had a lot of people reach out to me over the years and ask me for advice, which I am, I’m happy to share, and then they tell me why I’m wrong and I’m like, you don’t have to do what I say, but you know what I mean. It’s amazing how many people, I don’t know if it’s insecurity of I don’t want to take advice from somebody. And again, I’m not saying I’m right, but it’s interesting how many people will ask you what you would do and then instead of saying, well why do you say that or Tell me more about that or help me understand why, that’s where you would go. They go, that won’t work because of this or it won’t work because of that. And I think it’s an interesting mentality, but I’ve seen it again and again over the years and I think it’s people who want to be mentored but that make it really hard to do it. Do you agree with that?

Dr. Addie Reinhard:
Yeah, I do. And I think you have to come into a conversation being willing to listen. There’s a lot of things that my mentors tell me that are total crap that I’m not going to do.

Dr. Andy Roark:
Thank you. I appreciate that.

Dr. Addie Reinhard:
Some of the advice that you’ve given me is just total crap. I believe it, but a lot of it is really good. And so maybe this is number three of being discerning about what you’re going to take with you and what you’re going to leave behind and being grateful for all of the knowledge that is given regardless because they don’t know what’s going to be appropriate to your situation, but you do. So listening, having an open mind and taking the nuggets that do apply to your situation and using those and then discarding the rest and still showing appreciation for all of it, I think is one of the ways that you can be really a good mentee or learner from other people. Because again, I’ve heard even today we had an advisory board meeting for MentorVet, so it’s like my 10 11 mentors that I’ve chosen to help me and MentorVet grow. And during the meeting some of our advisory board members say some stuff that I don’t really necessarily agree with and yet I will sit and I will listen to their point of view and their perspective, take notes and again, take what applies and then discard the rest. But they don’t need to know that they have a bad

Dr. Andy Roark:
Idea. Oh yeah, no, I am so proud to unveil the biggest project I have ever worked on. This is a partnership with NA VC’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 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 value setting. This is basic strategic planning. It is understanding different communication styles, and I have my friend Stephanie Goss helping teach that session. It is 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.talk is in here and my GPA talk is in here. Everything about the North stars, everything that I lay out where I’m like, this is just so essential to managing people. 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, definitely who’s becoming a new practice owner. It’s 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 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 on demand whenever you want.
It’s broken up, it’s eight hours, it’s got race ce, it has the uncharted VetFolio certificate with it. It is there. It is accessible. I really hope that people will take this and put it to work. I went really hard on this. It has been years in the making and refining to get this content down. So it is really for everybody who is leading and managing other people in vet medicine. I hope you’ll 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 this show note. I hope you’ll have a look. Let’s get back into this episode.
Well, I mean I really love that idea of being grateful for all of it and then taking the parts that you need in going on. I think that’s really insightful. I think the specificity is really important. I think one of the things in mentorship that is hard is when you look at someone and you say, I feel like I could learn from you, but I don’t really know what I need or I don’t really know how I think I have always struggled in approaching people that I just admire, but I’m like, I don’t know how you can help me. People that I admire who I know have insight on a specific headache that I’m wrestling with, that’s easy. I reached out to Justine Lee, Dr. Justine Lee, who’s the founder of Vet Girl yesterday, and I was like, Hey, I got this thing I’m kind of rolling around.
It was the online education stuff and I was like, I haven’t talked to Justine in a year since it’s before the pandemic, but she’s great. But I just said, Hey, this is basically what I’m looking for. Would you have 10 minutes to kick this around with me? And she made 10 minutes happen yesterday afternoon and we just kicked it back and forth real fast and that was that. But I wouldn’t feel comfortable reaching out Justin and being like, Hey, let’s just chat. You’re awesome. I’d like to just chat with you. It was having that problem that opened that door. Do you think that that’s true too, or do you feel like you can strike up those relationships without having a specific headache that you’re actually motivated to deal with?

Dr. Addie Reinhard:
I think there has to be a little bit of both. I think the relationship building piece, and I will say there’s a difference between that flash mentorship, the one time conversation with somebody versus the long-term mentoring relationship, which both can be used honestly, when I go to conferences, I’m having flash mentorship moments, the entire conference I’m sitting down for two, three hours talking to somebody about issues and their life and my life and learning things along the way. But I think for a long-term mentoring relationship, the aspects of building the relationship outside of just every time there’s a fire, I’m talking to you, but sometimes just talking to you when there’s not a fire and just catching up and saying hello and celebrating the wins too and the good things that happen. And I think that aspect of relationship building becomes important. And especially if we’re talking about mentors outside of the clinic and hospital setting too.
And I think that would be something that I would encourage everyone to consider. If you’re looking for mentorship, look for it both in your hospital or your clinic or your organization and look for another mentor outside of your hospital or clinic or organization because that’s going to be a little bit safer space to talk about some of the stuff that you’re facing. Then if you’re having a conflict with a coworker, maybe your boss Ash mentor is not the best person to be the first person to bring this up with. Maybe you need to process some of this stuff in a safe space outside of the workplace. So really thinking about that external mentor and the external mentors is one that that’s more important on the relationship building side of things. And honestly, a lot of my mentors, I would call friends as well. Oh

Dr. Andy Roark:
Yeah. I think it’s really hard to tease ’em apart. I kind of feel silly calling some of my friends mentors. You know what I mean? I was just going to say it could be

Dr. Addie Reinhard:
Both. We can be friends and mentors,

Dr. Andy Roark:
Andy. We can be friends and mentors. I always going to say, one of my mentors, he runs a comedy theater, an improv comedy theater, and he’s my friend, he’s younger than me, I know him from comedy. But we have lunch once a month and just compare notes on how the comedy theater is going and how my business is going. And there’s actually a lot of weird similarities between getting people to come together and perform on a comedy stage and getting people to come together and perform on a veterinary CE stage. It’s kind of weird and kind of awesome. But I just say that one to sort of validate the idea of having people outside of vet medicine that you can learn from. I tell you, I had significant career epiphanies talking to that guy and been like, oh my God, I have been looking at this the wrong way. And just, I don’t know that I would even have those epiphanies if it was vet medicine. I think it would be too close to make it pop out. But it is sort of weird to think of those people as mentors. But I don’t know. I would definitely say he’s definitely on my board of directors. Like I said, we do our monthly lunch, we talk about life and what’s going on, and I have gotten a ton out of that relationship.

Dr. Addie Reinhard:
I love the finding somebody outside of the field because I was just thinking about some of my friends who have supported me in various things that I had no clue what was going on, tech stuff for it, kind of things that can be really beneficial. And like you said, getting that external framework, that was probably the most valuable thing I gained from my master’s program is just a lot of people from different disciplines coming together and I learned new frameworks, new ways to think about the world. So yeah, encourage anybody to look outside of the field too for mentors.

Dr. Andy Roark:
What does a mentor conversation sound like for you? And I know that’s a weird question to ask, but I think a lot of people, they don’t know how to get started with a relationship like this. They don’t know how to ask someone how to ask someone for guidance in a way that doesn’t feel weird or seem weird. No one’s taught most of us how to get insight out of other people without it feeling strange. There’s a lot of people I know who do podcasts, and the reason I think they do a podcast is because they’re too self-conscious to just talk to people without headphones and a microphone. So you just say to somebody, Hey, would you be on my podcast? And then you ask them the questions that you want to ask them, but you feel safe because you have a reason to ask them. And I’m like,

Dr. Addie Reinhard:
Are you saying this from personal experience?

Dr. Andy Roark:
No, listen, I don’t listen. I can’t. Maybe

Dr. Addie Reinhard:
Is this a,

Dr. Andy Roark:
I mean, there are definitely people out there that I’m like, this person is amazing and I don’t know how to be their friend. And so this is a gateway to me having a conversation with them that has absolutely happened. I can come up with a list of people in vet medicine I admire, who I have admired from afar, but I had no reason to talk to them except that they then published something or I read something and I was like, aha, this is my chance to be this person’s friend. And so I do it. But I don’t know, it’s weird, especially if there’s a significant difference in where you are in your career and things like that. I think one of the biggest mistakes people make with mentorship and sort of just full, the biggest mistake they make with mentorship is they think that the mentor is supposed to reach out or the mentor is supposed to make it happen.
I was like, the mentor has the least to gain in this relationship. I mean, I know that mentors get a lot out of it, but I’m not walking around looking for people to try to give advice to. And I don’t think other people are either. You know what I mean? I feel like it has to be driven by the person who wants to grow and develop and knows what they’re trying to do. But I feel like it’s often framed as mentors need to recruit mentees, and you hear, come to our hospital and we’ll mentor you. And it’s trying to plug them into that system as opposed to saying to the person, where are you trying to go? What are you trying to do? So yeah, I don’t know. I dunno if that resonates at all if you feel that way, but I think a lot of people just, I don’t know that they know what the conversation sounds like.

Dr. Addie Reinhard:
Yeah, I think you make a lot of good points. And typically when I’m looking at a mentoring relationship, a lot of it kind of evolves naturally just because I’m genuinely interested in learning more about the individual and their career. So oftentimes a mentoring relationship might just start off with me learning more about where you’ve been in your career. What are some of the challenges that you faced along the way? How did you overcome those challenges? And I will typically, and it is something that we teach our mentees going through a lot of our mentee training and the MentorVet program is just be proactive. And like you said, set up those meetings, set your own goals for what you want the mentoring relationship to look like. And if you come at a situation with, and usually if I have a challenge, I will just lay it out on the table and say, Hey, here’s what I’m going through.
Have you experienced anything like this before? Make it a conversation. What would you suggest? How have you navigated similar things in the past? But I think a lot of times that initial and it’s scary, right? Reaching out to somebody that you think would be a good mentor for you and making that initial connection and contact, but just look at it as getting coffee with somebody, just learning about them, getting to know them a little bit more. And then maybe not on the first meeting disclosing all your challenges and stressors, but maybe on the second or third meeting after the trust is built a little bit and you kind of see that it’s a good fit because not every mentor mentee is going to be a good fit. So you might meet with this person one time and be like, we didn’t really connect. And I’ve met with quite a few people who I’m sure are phenomenal mentors to other people, but maybe we just didn’t really have that spark of connection that will create a successful relationship.
So it’s funny, there’s a lot of parallels to dating here. It’s kind of weird, but when you think about dating people, not every person that you go on a date with is going to be somebody that you want to marry for the rest of your life. And same thing with mentors. Not every mentor that you meet is somebody that you want to be your mentor forever, but being willing to meet people and trying to find people that fit your personality, that have similar shared experiences and some differing experiences as well to broaden your perspective. Yeah.

Dr. Andy Roark:
How often does that happen, do you think? I was having that thought as well as there are some people I reach out to who I know are brilliant and they’re super smart and they’ve been very successful. And I talk to them and after the conversation is over, I’m like, I don’t know that they know they saw me or that, you know what I mean? It was like, I hear what they’re saying. Or maybe just the fundamental way that they think is not in alignment with mine. I’ve seen that a lot with doctors where there are brilliant doctors out there and I will talk to them about a case and they’re like, oh, well I would just do this and this is why. And I’m like, I would never do that. I mean, I’m sure they’re right, but their thought process is absolutely not one that I would take. And so it’s hard for me to say, ah, I’m going to learn from this person and you and I are not wired closely enough alike to make this easy. I feel like good mentorship should be easy. Do you want to put a ballpark percentage on? What percentage of people are you like, no, I appreciate you, but this is not going to be a good fit.

Dr. Addie Reinhard:
So some statistics from our platform of how, and this is finding people who we think would be a good fit or people are self-selecting mentors, the proportion of relationships that are probably first time successful right off the bat, maybe a third of those relationships really spark and turn into something longer lasting. And I would say the same thing. So when we first started doing programming, I pretty much was the paired mentor for everyone going through our program. And I would say about a third of the people I reached out to as a mentor and said, Hey, I’m your mentor. Let’s meet. And they never contacted me. A third of them, we met one time and then they’re like, I’m fine. I don’t need any support. I’m like, cool. And then a third of them are people that I still sometimes chat with today. I met with one of my mentees who I mentored two years ago for monthly for about six months.
And she reached out to me and said, Hey, I need some support. Can I chat with you? And we met for an hour today and it was great. And it was like, oh, we just picked up where we left off. So I would say about a third of the time, and it’s funny because I was thinking as you were thinking about, or as you were saying, the thing about doctors and not agreeing, there was this relief that I would always ask for some support from in my early career. And every time I would ask her advice, she would give me what she would do in the situation. And I’d leave the conversation being like, I’m not going to do any of that. And then it got to the point where I was like, wait, why am I even asking her for her advice on this? Because we’re fundamentally different on how we practice. So again, I would say about a third at the time.

Dr. Andy Roark:
Yeah, that totally makes sense. That tracks. Addie, you are amazing. Thank you so much for being here. Where can people learn more about MentorVet?

Dr. Addie Reinhard:
Yeah, so check us out on Instagram at MentorVet or on LinkedIn as well as Facebook. We are at MentorVet one on Facebook because turns out there is an old organization that was Mentorship for Veterans that currently is the at MentorVet on Facebook. But you can also follow me personally on LinkedIn. I post a lot of stuff around my journey through entrepreneurship and mentorship and all the things. And also at our website, MentorVet.net

Dr. Andy Roark:
Outstanding. I’ll put links in the show notes to that. And thanks for being here guys. Thanks for tuning in and listening. Take care of yourselves, everybody. And that is our episode, guys. I hope you enjoyed it. I hope you got something out of it. Thanks to Addie for being here. So enjoy her. Check out MentorVet, if you’re not familiar with it. It’s a great organization. Addie’s doing really wonderful things over there. Guys. Take care of yourselves. Be well everybody. Talk to you later. Bye.

Those You Know, But Don’t Know

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When I used to drop my kids off at daycare, my primary focus was ejecting the children from my car so I could get on to my mile long to-do list. Screeching tires, flying gravel and… was that a little girl wearing a halloween costume in March? I passed through the parking lot as quickly as possible.

From an efficiency standpoint, this was great. I was knocking things off the list and making stuff happen! From a relationship-with-daycare-workers-and-other-parents, it was pretty bad.

Relationships are funny and fickle things. You can’t put them on a checklist and mark them off. You can’t show up, say a compliment and walk away. No matter how charming you are or how much corporate communication training you’ve had, building relationships takes time. It requires doing the work to know another person. Putting in the time of simply being together. There are no shortcuts.

I spent years as a veterinarian ducking into and out of exam rooms like a game show contestant navigating an obstacle course. I took great care of pet owners and pushed appointments quickly and efficiently. But at the end of the day, when my technicians would go home, I had no idea where they went. I didn’t know what they did, or who met them when they got home.

I knew the people I worked with, but I didn’t really KNOW them. I knew their competencies and behaviors. I knew their quirks and what made them laugh. I didn’t know, however, what they cared about, how they thought, or what they aspired to become in the future. I didn’t know what they wanted to accomplish before they died, what their most meaningful life experience had been, or what made them proud at the end of the day.

I regret not knowing those things. 

I think a lot of us believe we don’t have better relationships with the people around us because we don’t have time to build those relationships. I’m not so sure that’s true. Recently I’ve been pondering the idea that maybe it’s not time that holds us back. Maybe it’s a lack of curiosity. Maybe we forget to wonder about people we see everyday. Or maybe we’re just too shy to ask people about themselves.

In my experience, most people are thrilled to have someone want to know more about them. They smile and open up. They feel special and seen. Asking deeper questions so we can better know others isn’t a weird thing in practice. Instead it’s usually a path to deeper, more trusting relationships. 

Who do you know, but don’t really know? What could you ask them today to start to make that journey?

Mastering Weight Management

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Dr. Taryn Pestalozzi, DVM, residency-trained in Nutrition, joins the podcast to talk about how she approaches difficult pet weight-loss conversations. Dr. Pestalozzi and Dr. Roark discuss the case of an obese Labrador Retriever named Greta, and how best to handle her care. As a veterinarian who practiced in GP for 7 years before running the Healthy Weight Clinic during her internship at Kansas State University’s Veterinary Health Center, Dr. Pestalozzi has fantastic and practical insight on how to motivate pet owners to make real changes for the sake of their best friends.

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LINKS

The Hill’s Veterinary Academy is a one site solution for educating the entire veterinary team. On the HVA, you can find FREE RACE CE from leading specialists and experts, patient-centric education beyond nutrition and flexible, on-demand content that fits your schedule. 

Hill’s Veterinary Academy: https://na.hillsvna.com/

Hill’s Body Fat Index Tool

World Small Animal Veterinary Association Nutrition Toolkit

Association for Pet Obesity Prevention

Pet Nutrition Alliance Calorie Calculator

Ohio State RER Calculator

All Links: linktr.ee/DrAndyRoark

ABOUT OUR GUEST

Dr. Taryn Pestalozzi received her bachelor’s degree from Smith College in 2008, before graduating with her DVM from Oregon State University in 2013. Dr. Pestalozzi was a general practitioner in the Portland, OR metropolitan area for 7 years before completing a clinical nutrition internship at Kansas State University’s Veterinary Health Center, where she managed the Healthy Weight Clinic. Dr. Pestalozzi recently completed her clinical nutrition residency at UC Davis Veterinary Medical Teaching Hospital.

EPISODE TRANSCRIPT

Dr. Andy Roark (00:07):
Hello and welcome everybody to the Cone of Shame Veterinary Podcast. I am your host, Dr. Andy Roark. Guys, I got a great one for you. Today is on mastering weight Management. This is super mega practical, what to say and how to say it. Podcast, I have got Dr. Taryn Pestalozzi here. She is residency trained in nutrition. She’s a joy to talk to. She is super practical and pragmatic, which I really love. She’s got great advice for setting up these weight management conversations in a way that actually get results and help us convince pet owners to make the steps they need to make to take care of their pets. Anyway, you are going to probably get some affirmation for things that you do out of this, you are also going to get some tips and tricks for things that you don’t do or ways to have these conversations that you haven’t had.

(00:55):
I am really big on this. I love it when we get insights on things that we do a lot of because little tweaks in those behaviors make a huge difference because we do ’em all the time. And so anyway, this episode is really good and it’s really useful. I think you guys are going to really, really like it. I have to say thanks to my friends at Hill’s Pet Nutrition for making this episode possible ad free. And I also have to say thanks to ’em for their Hill’s Veterinary Academy. Guys, if you have not checked out the Hill’s Veterinary Academy, it is a fantastic learning platform that Hill’s is putting out and they are steadily growing and expanding and it is packed full of good stuff for training your team. It’s got free RACE CE in there. There’s so much that’s going on and they’re really putting a lot of effort into it. So anyway, if you are not familiar with the Hill’s Veterinary Academy, I’m going to put a link down in the show notes. You can give it a Google if you want to go that way, but check it out. Go see what they’re doing. This is really just a neat little gift through our profession. So anyway guys, that’s enough of that. Let’s get into this episode.

Kelsey Beth Carpenter (01:55):
(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 (02:12):
Welcome to the podcast, Dr. Taryn Pestalozzi. How are you?

Dr. Taryn Pestalozzi (02:16):
Good. Thanks for having me.

Dr. Andy Roark (02:17):
Oh, I am so glad that you’re here. I am looking forward to this. So, what I wanted to talk to you about today, so when you did your internship, you did your internship at Kansas State and you ran the healthy weight clinic there and I see a lot of very heavy pets. I saw a cat that was rapidly gaining weight last week and it bothers and this is a passion of yours. It’s something you have a lot of experience in. I just want to run through a healthy weight campaign with you today and just be like, alright, tighten. Let’s tighten the bolts down here and I want to make sure that I’m running a program and then I can carry this out and I want to get weight off of pets and so are you okay to run through a case with me and just start to finish and get me set for success?

Dr. Taryn Pestalozzi (03:22):
That sounds great. Let’s do it.

Dr. Andy Roark (03:24):
Let’s do it. I have got a 100 pound female spayed chocolate Labrador named Greta. So Greta is eight years old and those hips ain’t what they used to be. Sure not. And I can see it. I can see that the muscle mass in her back legs is not what it used to be. And owners are not reporting mobility issues. She’s not, her gait doesn’t appear to be, you don’t see her walking going, oh boy, but she’s eight and I can see that when I look into my future scope where I look ahead a year or two. And so this dog is probably 20 pounds overweight. I think she should be, honestly, if I’m really serious, she should probably be a 75 pound lab, but she’s a hundred. I could be okay. I think if she’s 80, I have to see it. You know what I mean? And you go,

(04:23):
I think 80 is about right. I have to see it, but I need some help in this. And I think that I can get the owners motivated, they love this dog. I think I can make a solid pitch for the lack of mobility that’s coming down the pipes and I want to really push and so I have not gone into this room yet, but I want you to help me. That’s how the table is set. Taryn, how do you treat this case? Where’s your head at when you’re standing outside this door to the exam room getting ready to go in?

Dr. Taryn Pestalozzi (04:55):
So I think the first thing is maybe keeping in mind maybe these owners haven’t come to see you for this problem. They’ve brought Greta in for her annual exam. Yeah, she’s in needs. So it can sometimes take people off guard when you bring up a topic and you get really fixated on that that they weren’t really coming to talk about. So first thing I think is to not forget your primary reason for the appointment. And if you need to schedule a follow-up to actually spend more time talking about the weight loss, do that. But then also consider asking permission to talk about her weight. Be thoughtful with your language. Don’t use fat humor. There was a consensus statement that came out of the UK between medical professionals and the human medical side and patients from obesity programs that talked about what kind of conversations and language are useful. So some of those tips are coming from that consensus statement sort of extrapolated that to our veterinary friends. So just be mindful that as you go into have this conversation.

Dr. Andy Roark (05:53):
Okay, talk to me a little bit about asking permission, right? Give me some language. I know we’ve had a lot of doctors who, and there’s a lot of technicians that are coming in and taking a history and they know that I’m going to come in and talk about the weight and it would be helpful to me if they could open this conversation up. So give me an example of what that, asking permission, I get the concept, what does that sound like?

Dr. Taryn Pestalozzi (06:12):
Yeah, I would start with an open-ended question probably. So asking the client how do they feel Greta’s doing overall? Do they have an idea of where they think she is in terms of weight? Do they think she’s a healthy weight? Do they have any concerns that she might be over or underweight? And that lets you also assess maybe where they’re at with that topic and then ask them, do you mind if we spend some more time talking about this today? I think I have some concerns.

Dr. Andy Roark (06:40):
I really like that question of do you have any concerns about her being over or underweight? It feels like a standard sort of form question and it’s not a judgment question. It feels like I’m taking a history or I’m filling out my form and it helps me know really quickly do they see it or are they blind to it? And we’ve seen, I mean I literally had a case just like this one chocolate lab a hundred pounds and the owners just could not see it. And I was showing them the body condition out and they didn’t get, that was rare. Definitely happened. I still remember it. They were just like, Nope, she looks like a five of nine to us and I’m just going, we’re not looking at the same things.

Dr. Taryn Pestalozzi (07:19):
Yup.

Dr. Andy Roark (07:19):
Anyway, a great question. Alright, I love it, Taryn. That’s super helpful. Alright, great. So I get get this conversation, get permission to talk to them about it. I like it. Let’s say that they’re like, sure we’re here for our annual exam, wellness, yup, we’ll totally talk about it. Where do you start to go from there?

Dr. Taryn Pestalozzi (07:39):
Yeah. Next would, as part of my exam I do a body condition score assessment on Greta and I think most of us are familiar with the body condition score concept. There’s a couple of different scale systems out there, so there’s a five point scale, there’s a nine point scale in the nutrition world, we tend to go with that nine point scale and if you need a resource in your clinic, the world’s mono, that association has some nice non-branded charts that you can use, but there’s lots of them available and I keep a copy in my exam room laminated and I actually pull it out and I look at it while I do my body condition score because the more you actually read through the definitions of what each of the points on the scale mean, the more consistent you will get. And also if you have your support staff and the other clinicians in your hospital all using that same tool and actually looking at it, you’re going to be more consistent across your whole clinic so that you start building a more reliable history as you’re seeing patients.

Dr. Andy Roark (08:35):
I tend to run into not opposition to this conversation, but just a level of passiveness that they don’t argue with you. They’re not like, no, we’re not going to do a weight loss program. But non-committal I think is how I would

Dr. Taryn Pestalozzi (08:57):
Yeah

Dr. Andy Roark (08:57):
And again, I’m going to lean into the hips in this case and try to make a real quality of life point here, but as I try to motivate for action and try to push through that non-committal place to get them on board with taking action, how can you support me there?

Dr. Taryn Pestalozzi (09:18):
Yeah

Dr. Andy Roark (09:18):
How do you do that?

Dr. Taryn Pestalozzi (09:20):
I think it’s common for a lot of us to maybe focus on those negative outcomes that we are sort of foreseeing in the future. And there’s certainly clients that might need that, right? They maybe need you to really kind of hone in on those negative potential outcomes because they might not budge without it. But going back to that consensus statement in human medicine, it’s actually more effective a lot of times to focus on positive outcomes of weight loss rather than the negative potential consequences of being overweight or obese. So I hear from clients all the time, even with minimal, it’s pretty small amounts of weight loss. They’re acting so much younger, I can see they look thinner. I’m getting compliments on how they look. I’ve had to make their harness smaller. And so really focusing on what the benefits are and what they might see as that progress happens, I think is often more motivating.

Dr. Andy Roark (10:14):
I like that. So what your counsel here would be in the case of a dog that’s overweight and a senior pet is maybe don’t, ooh, she’s getting older, but instead talk about what we could accomplish and she could have the best years of her life. I mean there’s quite possible we could turn back the wheel of time a couple of years and you would see her

Dr. Taryn Pestalozzi (10:35):
Sure, let’s give her the best quality of life where we can as long as possible. And to do that, let’s really focus on getting her down to a lean ideal body condition so that she can be mobile as long as possible and do the things that she loves.

Dr. Andy Roark (10:47):
I’d much rather have the positive conversation than the negative one. No one wants to go tell someone, I’m really worried your dog is going to get worse and have hard time getting up. And that’s not a fun conversation.

Dr. Taryn Pestalozzi (11:00):
No, it’s not at all.

Dr. Andy Roark (11:00):
Appreciate this perspective. I like this so motivating from here to hear to action. I do like that. Any other advice for trying to get buy-in and build momentum?

Dr. Taryn Pestalozzi (11:11):
I think it’s important to try to get all of the humans in the household on the same page. There’s always going to be that person who maybe causes lack of compliance, sneaking treats or they don’t see the importance of the plan. So trying to get everybody involved in that conversation and on the same page is always a good idea if you can, it’s not always possible, but I think that’s going to be helpful for your success.

Dr. Andy Roark (11:40):
What does that look like when you go into the exam room? Because it’s always like my husband does and he’s not there.

Dr. Taryn Pestalozzi (11:50):
They throw each other under the bus. Right?

Dr. Andy Roark (11:52):
Business. That’s totally true. It could a hundred percent not just because they say it’s the person who’s not there. That doesn’t mean that really is.

Dr. Taryn Pestalozzi (12:00):
Sure. I’ve had clients pull me aside, tell me to kind of tell on their spouse or their partner. So I think if you can have ’em both in the same room, maybe you do have schedule a follow-up appointment and ask if they can both be there or I’ll be there. But otherwise, I mean I’ve had clients ask me to write letters to their significant others on letterhead to tell them they need to stop feeding the pet. I haven’t had that as much since I came to nutrition, but I was a GP for seven years before I did nutrition, so I definitely got that apps that several times

Dr. Andy Roark (12:31):
Oh that’s so funny. Alright.

(12:33):
Got it.

Dr. Taryn Pestalozzi (12:34):
I mean you kind of have to play it by ear, but I think trying to get buy-in from everybody is useful.

Dr. Andy Roark (12:39):
Oh, I love it. I just wondered if you had some special tool like I video myself and text it to them. I don’t know. I don’t know. I was just curious if you had any tools for wrangling people in.

Dr. Taryn Pestalozzi (12:48):
Yeah, we do the best we can.

Dr. Andy Roark (12:49):
I love it. This feels so daunting. 25 pounds is a lot. I mean 20 pounds, it’s a lot. 20 pounds per person is a lot and a person weighs more than a hundred pounds. Generally it’s a lot to lose. We’re talking 25%, 20, 25% of this pet’s entire body weight. How do set, it’s not going to be done in a week. This is going to be a process. How do I set expectations so that the clients are not like we’re going to try hard for five days and then I don’t see any changes I’m giving up, help me set us up for success in this and what’s going to be a marathon?

Dr. Taryn Pestalozzi (13:33):
Yeah, I think that’s a really good question, a thing to consider. So there’s a few things. First, the Association for Pet Obesity Prevention puts out annual reports that do surveys of both veterinary clinics and pet owners. And on the most recent data from 2022, they reported on average maybe 30 to 40% of pet owners who had tried a weight loss plan either reported their pet was not successful or they even gained weight. So trying to mitigate that is going to be helpful for long-term compliance. So the first thing is being specific in your recommendations so that you are setting them up for hopefully success right away and not sort of initial lack of weight loss, ribbon weight gain. We can’t always prevent that. So I do warn owners this is a process, it’s going to take us a while. We might backslide occasionally, but we will hopefully be moving forward the majority of the time. I think the second thing is coming up with a timeline. If Greta is a hundred pounds, let’s say that she is, I don’t know, 20% overweight, so she’d be a seven out of nine. For example, if our goal’s a five, so she’s actually 20 to 30% overweight as a seven out of nine. So then we can say, okay, well she’s 20 to 30% overweight and she loses on average 1% per week, which would be the bottom of our target range, then it’s going to take us at least 20 to 30 weeks to get her down to ideal weight. And that’s on an ideal sort of situation. It often takes longer. So giving them a timeline of what to expect I think is helpful.

(15:12):
Then the last thing is just really monitoring so that you can be making adjustments to the plan. I normally see these patients ideally every two to three weeks, or if I’m not seeing ’em in person, I’m at least doing a virtual check-in appointment. I’ll have them weigh them on their own and send me the wait before the appointment and then we can spend maybe five to 10 minutes on the phone or on a video call having that conversation of what’s next, what adjustments do we do or not need to do, what do we need to troubleshoot? And that way we’re keeping progress moving forward hopefully and not running into plateaus that just continue on and on and on.

Dr. Andy Roark (15:48):
Yeah. Okay. I got a couple of questions, so I really like this. So tell me what a specific recommendation sounds like when you say that. How far down the rabbit hole are you going as far as the specificity of what you’re giving to?

Dr. Taryn Pestalozzi (16:03):
Yeah, well, I mean as a GP was totally guilty of this, and I know lots of other practitioners do this too, of they’re overweight to say, oh, just drop their food a quarter of a cup, right? Yeah.

(16:14):
And we go, okay, great. We’ll see you in six months for your net set of vaccines, have a good life, whatever. And instead, what really we should be doing is giving a specific feeding amount. So the first thing is, as much as we can getting an accurate assessment of how much the pet is currently eating, so all the food they’re getting, any treats, any foods they’re going to use to give medications, which often clients forget to include in that history when you ask. And from there, I normally would drop their intake probably 20% initially if, I don’t know if they’re the kind of client who says, oh, well I feed the green bag, it’s really expensive so I know it’s good quality and I just fill the bowl up every two days. Well then I would start for a dog with their resting energy requirement and if they’re a cat, I’d start at 80% of the resting energy requirement.

(17:02):
There’s two methods, so a lot of nutritionists will use an estimated ideal weight to do those calculations and that’s great. That’s how I did it when I ran the Healthy Weight Clinic at K State for that year, and it’s definitely a successful method. That’s also what AHA has in their weight management guidelines. At Davis, we do things a little bit different. We use their current weight, not an estimated ideal weight. We want to use a true number and not an estimate to make all of our calculations. Both methods work really, you’re just picking a starting point and you’re adjusting from that starting point. The other thing we do is we recommend they weigh their food in grams, or if it’s canned food, then at least an easy fraction of a can because we want to be as accurate as we can so that we can make small adjustments as we go.

Dr. Andy Roark (17:46):
Okay. Yeah, that totally makes sense to me. I like the timeline idea as well. I think that’s part of the recommendation. It’s funny when you say 1% per week, I go, okay, well that’s six months, which feels very different. And just saying out loud, this is minimum of six months, just so you know,.

Dr. Taryn Pestalozzi (18:05):
That’s like best case scenario. If there is six out of nine, I can probably get them down to ideal and figure out what it takes to keep them there in about six months. If they’re seven or above, realistically you’re talking more like nine to 12 months or more.

Dr. Andy Roark (18:19):
Yeah.

Dr. Taryn Pestalozzi (18:20):
They’re that 11 out of nine, maybe you’re talking 18 months. So it’s not a short process. It does take a dedicated owner and that’s why you have to be their cheerleader and positive reinforcement of the owner. You’re doing a great job. I’m seeing improvement. Let’s keep going. We give prizes. When they reach their target weight.

Dr. Andy Roark (18:38):
What kind of prizes do you give?

Dr. Taryn Pestalozzi (18:40):
Well, at Kansas we took a photo of them and we were going to make, this was right as I was leaving, we were going to make a wall of fame. So I dunno if that or wall of success kind of oncology departments like to do with their pets finished chemo and then I would give them slow feed bowls or leashes or frisbees, that kind of stuff. If we had plants who are really hesitant to weigh their pet’s, weigh their food, we actually had some gram scales and we would just give them one

Dr. Andy Roark (19:07):
Wow.

Dr. Taryn Pestalozzi (19:07):
Say, can you please just do it? I didn’t do that for everybody, but it was like I was getting a lot of pushback. Yeah.

Dr. Andy Roark (19:13):
Well it shows how serious you are about it, for sure.

Dr. Taryn Pestalozzi (19:16):
Yeah.

Dr. Andy Roark (19:17):
Talk to me a little bit about what these, so I really like sort of the monitoring part. Talk to me a little bit about what these monitoring recheck appointments look like. So you’re like, yeah, we see ’em back two to three weeks. First let’s talk in person. But I think the virtual is, there’s a lot of opportunity there, but just if you have them sort come back into the clinic, what does that recheck look like? I know everybody’s busy, you know what I mean?

Dr. Taryn Pestalozzi (19:37):
Sure, yeah.

Dr. Andy Roark (19:37):
So we’re trying squeeze it in. What does that experience for the clients look like?

Dr. Taryn Pestalozzi (19:42):
So it can be a quick appointment. So my sort of rule of thumb is if I’ve made any changes to their plan, I try to see them back in two to three weeks. If we haven’t made any changes, I push it out like a three to four weeks. So on average every three weeks or so, and it could be probably at the most a 15 minute appointment if you are sort of efficient in how you’re running it, if you’re leveraging your support staff so you could have your support staff go in and body condition that animal if you’ve gotten everybody well trained and on the same book in that regard, get a weight and take a little bit of a diet history. How have things been going? Are you feeding them out? We talked about last time, have you run into challenges? What sort of troubleshooting?

(20:21):
I mean, I think the classic example I give to students is they come in and they haven’t lost any weight and it’s December and you find out that, oh, the in-laws are in town visiting for the holidays and they’ve been feeding the dog a ton of milk bones, so maybe we don’t need to make a change that visit. Maybe we just need to send the in-laws home and get back on track. But if they have kind of lost in that one to two-ish percent percent of body weight per week, then great, we don’t make any changes. We see you again in a few weeks, reassess. If they have not lost as quickly as we’d like or they’ve gained weight, then I’d probably drop them about 10% of their daily caloric intake.

Dr. Andy Roark (21:03):
Okay.

Dr. Taryn Pestalozzi (21:03):
They’re losing too fast, then I’d up ’em 10% and I’d see ’em again in two to three weeks and we’d reassess at that point. And I keep in mind treats. So we plan for treats in our plans. Yeah,

Dr. Andy Roark (21:14):
Gotcha. Talk to me about what losing too fast looks like. So that’s what I was going to start to poke you about a little bit was like when they come back in two to three weeks, what are we looking for? And definitely, I like the idea that we’re going to put ’em on a scale. We’re going to put ’em on the same scale they used last time, so we get some consistency and then if we’re not seeing any weight loss at all, we’re going to start to adjust. And that all tracks to me, when do I have to start worrying like, oh, we’re falling like a stone? Because I suspect that pet owners are probably pretty psyched. They’re like, this is great. We’re making real headway. Greta’s not really thrilled, but the pet owners, I could see them being on board. What am I looking out for there?

Dr. Taryn Pestalozzi (21:56):
Yeah, I mean I’ve had that happen. It’s less common than you might think, but I mean, I’ve had dogs that got boarded when they were sort of starting their plan and they lost like five, 6% in a short period of time, like 10 days. And so our concern there is two things for both species we’re concerned about lack of muscle, muscle losing lean muscle. You mentioned Greta, you were concerned about the muscle in her hind end. So that’s great. I would encourage everybody to actually record a muscle condition score every visit. It doesn’t have to have a number. The world’s Monolo Bed Association actually doesn’t use a numerical scale. It’s just normal or mild, moderate or severe atrophy. And then I’d also be concerned maybe in our cat patients about something like hepatic lipidosis, but that takes a lot. It takes very dramatic sort of extended in tants or hypoxia to get hepatic. So I don’t get too worried about it. But certainly for our cat patients, if I’m starting a new plan, I am really conscious of how I tell owners to transition ’em onto a new food and give them criteria for when they would need to call us. If they’re not eating the new food or they’re not doing well,

Dr. Andy Roark (23:04):
How does the virtual check-in visit work? Because if they’re not there and you don’t have your scale, what is that experience like for the pet owner?

Dr. Taryn Pestalozzi (23:11):
Yeah, I mean it’s a pretty similar, I think outline to how the appointment runs. But what I do is I made a little handout for my owners that shows them some specific photos. I want them to take the photo from the side, a photo from above, and then one of their face if you want to use the body fat index tool from Hill’s and University of Tennessee, I’d also take a picture from behind them staring at their butt. And that lets me just assess roughly their body condition or their body fat index. And then I have the owners weigh them and I just tell ’em, find a consistent way to weigh them, whatever that is. They’re coming to your clinic just for a quick swing by the lobby scale. Or if they have a scale at home, they can get an infant scale or even a floor scale for a big dog relatively inexpensively online. And so they just email me in advance their weight, they send me their photos. I can do the math that I need to do right before the appointment, and then it takes 10 minutes or less to have that conversation about do we need to troubleshoot anything? How fast or how slow were you losing weight? And what adjustments do we need to make?

Dr. Andy Roark (24:14):
Got it. Perfect. That totally makes sense. Good deal. I like this. This seems good. Are there, so we’ve got a plan, we’ve got some good motivators, we’ve got specific recommendations. We’ve got a follow-up plan. I really like the ongoing monitoring. That makes a ton of sense. I a hundred percent see how I can lean on my technicians to help me with this and to run this program. That’s a big deal to me. I really like nutrition for technicians and they can make my job really easy and we can make a real impact together. But anyway, so I like all this. Is there any final pearls pieces that I want to make sure that I’m not forgetting

Dr. Taryn Pestalozzi (24:54):
And I maybe skipped over it? So in our specific recommendations,

Dr. Andy Roark (24:58):
mm-hmm

Dr. Taryn Pestalozzi (24:58):
the majority of these patients should be on a therapeutic, a prescription weight loss diet because if we start restricting their calories, especially if they get below RER or even 1.2 times RER, if we’re talking about dogs, we can cause nutritional deficiencies if we feed a non-therapeutic diet for a long time because those therapeutic diets are fortified with extra protein and vitamins and minerals to account for the lower calorie intake that those pets are having. They also help them with stain full, so satiety, if they’re canned diets, they have a lot of moisture. If they’re kibble, they might be what they call air puffed, so bigger kibbles to take up more volume. And then they also often are high in fiber to help them feel full. So you really should be using a diet like that if you’re going to institute a weight loss plan unless you’re doing small amounts of weight loss and you’re being very conservative with how fast you push them.

Dr. Andy Roark (25:50):
Okay. Define RER for me real quick.

Dr. Taryn Pestalozzi (25:53):
Resting Energy Requirements, and there’s a couple ways you can calculate it. I’m going to give some resources I think at the end that we’ll show you how to do all the calculations and walk you through how to do a plan like this.

Dr. Andy Roark (26:05):
Cool. I love it. And then I want to dig into this a little bit. I think that’s a great point about moving to therapeutic D because one of the pushbacks I always get is, well, I can just, there’s a light version of what they eat. Can I just use the light food? And I want to be supportive of pet owners and kind meet ’em where they are. And at the same time, I do feel like I’m only going to get one good shot. Often it’s one good shot, they’re going to make an attempt and if it doesn’t go anywhere, they’re going to kind of say, well, I guess she’s just a big girl and that’s what she’s going to be. And that’s that. So break that down for me a little bit as far as where your lines are when you’re like, no, it’s time to go to the therapeutic diet. I want to be confident when I make that recommendation to switch to a therapeutic diet and say, yes, this is the play we need to make. Where are your lines? Can you solidify that for me a little bit?

Dr. Taryn Pestalozzi (27:04):
It’s never wrong to pick a therapeutic diet for weight loss unless they have comorbidities that require other nutritional strategies. And there is not a commercially available combination diet. So there are combination joint support and weight loss diets. They’re a combination hydrolyzed and weight loss diets, et cetera. So it’s not wrong if you can find an option to do that other than it’s more expensive, I think that’s always the safe way to go. If I had a patient that did have other comorbidities, that’s the time to talk to a nutritionist or at least call the vet consult line for one of the therapeutic companies to talk to them about the case because maybe that pet really needs a homecooked diet to be able to accomplish weight loss and safely manage their other disease. But if I was going to go with a light or weight management diet over the counter, I’d be looking at patients that are maybe a six out of nine,

(28:02):
Or they have a calorie intake that’s already quite high. So if they’re eating 1.6, I’m talking about a dog right now, 1.6, 1.8 times their resting energy requirement, then I can probably reduce them at least for a while on their normal food and be safe. If they’re starting below that, which often these obese pets are, they have slow metabolisms, most of them. So if they’re starting at 1.2 or one times their resting energy requirement, then it’s not safe because I’m going to have to be cutting them back over this six to nine to 12 month process. We’re going to be making gradual reductions most likely. So we’re going to reach a point where it’s not safe for them to eat a regular diet over the counter. And I think that’s another takeaway is to talk to owners about the fact that this diet is not as short-term diet. Most of these pets have a low metabolic requirement, even once they’re at ideal body condition, so they really should be on a weight loss diet long term. I own one of these dogs, she’s on a weight loss diet for life unless I have to make a switch for another reason.

Dr. Andy Roark (29:05):
Gotcha. That makes sense. Yeah, that’s wonderful. Any other pearls I should pick up here at the very end?

Dr. Taryn Pestalozzi (29:12):
I mean, I think we’ve talked about a lot of them. It’s really about pick a starting point, monitor,

Dr. Andy Roark (29:17):
Yeah.

Dr. Taryn Pestalozzi (29:18):
Make adjustments, be a cheerleader. Those are the keys that people miss and that are what actually result in success. And I mean, we had roughly a 75 to 80% success rate and healthy weight clinic at Kansas when I was there. And most of the cases that weren’t successful, we had lack of compliance or we lost a follow-up. So I think if you work the plan so to speak, you can help a lot of these pets. And there’s like 60% of both dogs and cats that are overweight or obese currently. So this is the case you see every day.

Dr. Andy Roark (29:49):
Oh, I mean, yeah, the overweight Labrador people were like, oh, that’s really a novel case. Sandy, you haven’t seen that before. Yeah. That’s awesome. You’ve given me a number of resources. I’m going to be linking like crazy in the show notes, which I always love. People love having a list of resources. Any other that you would recommend if somebody’s just like, I love this, I love what you’re talking about. Where do you refer people who are nutrition geeks? They’re just like, yeah,

Dr. Taryn Pestalozzi (30:16):
Anymore. I’ve got a few. So the first one that will really walk you through this step-by-step is that 2014 aha weight management guidelines. There is a later like an updated version, but the 2014 as well. The meat and potatoes of this topic is the world’s model of that association has a nutrition toolkit. So that’s where you can get your body condition, your muscle condition, other resources for your support staff. Pet Nutrition Alliance does have a little online calculator you can use. I think they may have updated the website recently, so I’m not sure how they’ve changed it. And then Hill has the Bed Academy with some cece type videos about weight loss. They also have the quick reco tool that can help you initially make a plan. And then if you want more about the stats from that recent annual survey, the Association for Pet Obesity Prevention website has the results of all of the surveys, but the most recent being 2022 and they’ve got good infographics and stuff.

Dr. Andy Roark (31:12):
That’s amazing. I’ll link up to all that stuff. Dr. Taryn Peal, thank you so much for being here. I so enjoy you.

Dr. Taryn Pestalozzi (31:19):
Great, thanks. It was so nice talking about it. This was a topic that I really like.

Dr. Andy Roark (31:23):
Well, yeah, it’s obvious. That’s why I had to have you. Anyway, guys, thanks for tuning in. Everybody take care of yourselves. And that’s it, guys. That’s what I got for you. I hope you enjoyed it. I hope you got something out of it. Thanks so much to Taryn for being here. I really enjoy her. I really enjoy talking with her about weight management. It’s a thing that we talk about a lot, but man, when you find someone who is really passionate about this subject and who has had a job, just having these conversations, these are important, and just because we have ’em a lot doesn’t mean that we shouldn’t take them seriously and really think about how we get better. In fact, it’s the conversations we have a lot that we should really focus on because that’s where we can make a real difference for the clients and the pets that we see.

(32:09):
I mean, I dunno. I think a lot of times in education there’s this push to find these unique things that rarely happen and to be aware of them, and that’s okay. I really think that finding the things that happen commonly and deciding that we’re going to be amazing at them, I think that’s how we really make an impact on the world through veterinary care. Anyway, that’s just how I feel. Guys, if you have not checked at the Hill’s Veterinary Academy, you should take a look. Go and check it out. It is their learning library, it’s their Learning academy. There’s so many resources there. It is a great, great, great source of knowledge on all things nutrition. I’ll put links down in the show notes, go and check it out. Thanks to Hill’s for making this episode possible, guys. Take care of yourselves. I’ll talk to you later.

Perception: It’s All How You Look At It

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Today I am thrilled with my dog. I am so, so happy. Do you want to know why? Because he only destroyed a very nice pair of socks belonging to my oldest daughter. 

For those of you who have been reading my letters for a while, you might remember that Skipper Roark is a devout anarchist. He lives life to the fullest and has no interest in joining the brainwashed “good dog tribe” that he hears me talking about every day I visit the clinic. He lives by his own rules… and Skipper hates rules.

Anyway, the socks he ruined were brand new and quite nice. He tore them to shreds while I was running errands with the kids. You might think this would make me angry or upset, but I’m not at all.

The reason I’m thrilled is because my daughter (whose dirty laundry was raided) was absolutely certain that Skipper had eaten at least one pair of underwear while on his rampage. We searched the area and… there was no underwear to be found. She was certain her underwear had been in the hamper… but “there’s none there now.”

I suddenly became absolutely certain that we were headed to surgery. It might involve the emergency clinic that night or our clinic in the morning, but surgery felt imminent. I started questioning whether it was worth trying to find someone who could scope him at 9pm. Guilt (I’m pretty sure I was the last one to close the laundry room door), logistics and medical expenses flooded my mind.

And then… My daughter found the underwear. It was rolled up in other laundry and well-hidden until her final, last ditch effort to set her father’s mind at ease.

Immediately I began praising bad dog Skipper. I hugged him and texted my wife (who is traveling and had no idea any of this was happening): “SKIPPER DIDN’T EAT ANY UNDERWEAR! HE’S A GOOD BOY!”

My wife’s response was nowhere close to as positive as mine. She responded “Well, did he eat something else?!” and was not happy about the socks. To be honest, I think she was even more irritated that I didn’t seem to remotely care about expensive hosiery being trashed.

And that’s the thing about perception. If someone tells you your dog destroyed socks, that would bother you. But if someone tells you your dog is headed to surgery and then says “Oh wait! We’re okay! He just destroyed socks!” you’re probably over the moon.

Hardship in life is often this way. When bad stuff happens, it’s not toxic positivity to try to look at things a different way. It’s just adjusting your perspective to make life a little easier.

Choosing the Rulers We Measure Ourselves By

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Jamie Holms RVT interviews Dr. Andy Roark about his recent article in Today’s Veterinary Business titled “Measuring Sticks.” They discuss how we determine our own self worth and the tendency for driven people to choose unhelpful and unhealthy measurements by which to judge themselves.

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

LINKS

ARTICLE: Measuring Sticks

Dr. Andy Roark Resources 

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

Jamie Holms RVT is a new chicken mom and the Administrative Manager for Dr. Andy Roark, Uncharted Veterinary Conferences. Jamie is passionate about helping the people who are helping pets and is a firm believer that the future of the veterinary profession is bright. Jamie is obsessed with baby goats, axolotls, hedgehogs, tea, plants (especially hoyas), kindle books, food, and sleep – not necessarily in that order.

EPISODE TRANSCRIPT

Dr. Andy Roark:
Welcome everybody to the Cone of Shame veterinary podcast. I am your host, Dr. Andy Roark. Guys, I got my good friend Jamie Holms on the episode. Jamie Holms is RVT. She’s a dear friend of mine. She’s the first employee I ever hired. We go way back. We go back like popsicles on the porch in summertime. That’s how we go back. All that to say, I’ve known Jamie a long time. And when I write articles that really speak to her, she often says, “Hey, can we do a podcast on that article?” And I have an article called Measuring Sticks about how we measure ourselves, how we determine our own worth. And I think a lot of us really driven people have a bad habit of choosing measurements that are unattainable. We measure ourselves in ways that are not healthy, they’re not productive, they make us feel bad. They don’t really motivate us in any sort of way that is sustainable.
And I think that we all should probably take a step back and just unravel the self-talk that we have around what gives us worth and what gives us value, and how do we measure ourselves and how do we measure success. And so anyway, that’s what we get into. If that sounds of interest, then you’ll like this episode. But anyway, Jamie comes on and we talk about the article and I kind of laid down a lot of thoughts about that. So anyway, guys, I hope you’ll enjoy this episode. Always makes me a little self-conscious to get interviewed on my own stuff, on my own podcast, but I don’t know, I write things that I think are interesting and that really speak to me and this is something I’ve been really thinking a lot about. And so anyway, I was really excited when Jamie said, “Hey, I really like that. Maybe we could talk about it.” So I hope you’ll enjoy the conversation. I think it’s a good one. Let’s get into it and see what you think.

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, Jamie Holms. Thanks for being here.

Jamie Holms:
Oh, I’m so happy to be here. Thanks for having me again.

Dr. Andy Roark:
I always enjoy having you on the podcast. For those who do not know you, you and I have worked together forever. It feels like you were employee number @drandyroark.com.

Jamie Holms:
Before you.

Dr. Andy Roark:
Before me, exactly. You hired me on @drandyroark.com and it worked out really well because that was my name and it went great. You are an RVT. We were just laughing that you are a rivett and not a live it.

Jamie Holms:
So true.

Dr. Andy Roark:
So true. You are the administrative manager for drandywork.com and Uncharted Veterinary Conference. And so that’s who you are. You babysit my tomato plants when I travel in the summer and sometimes my bad golden doodle skipper.

Jamie Holms:
He’s not bad. He’s misunderstood and he loves me so much.

Dr. Andy Roark:
He does love you a lot. According to behaviorist Lisa Radosta, he has low confidence, is his problem.

Jamie Holms:
I love that that’s how we ended up here. That’s so funny because I wanted to talk about this article and I told you I wanted to talk about this article and I was like, I think I’m going to lead in with talking about Skipper and his confidence issue.

Dr. Andy Roark:
His confidence issue. Okay, fine.

Jamie Holms:
So this is perfect.

Dr. Andy Roark:
Okay. So I have a goldendoodle named Skipper who is just as a side, he’s not what you would call a good dog. He lives his truth openly and it’s not one of obedience and the thrill of making his owner happy, but he’s his own person and he does have a trait that drives me nuts as he’ll piddle on the floor when people come over or he gets excited. And so I talked to Dr. Lisa Radosta, she’s coming onto the podcast and I had her on to talk about inner cat aggression or something, and I did that thing where I was like, hey, while you’re here, can I ask you about a case? And I told her about Skipper and she asked me a bunch of questions about what he does with his ears and how he sort of behaves.
And the takeaway I think from her not really getting to see him was she thinks that this is sort of a conflict response and that he has confidence issues and that’s why he meets people in piddles. And so I have been trying to work on my golden doodles confidence and it is the most ridiculous project I have ever gone on. But I don’t know, I’m just going to stop and say I do not know if we are making progress. For three or four, five days I’m like, we’re nailing this and then there’s just a setback. And I’m just like, his confidence is it cannot be saved, I don’t think if he’s not a confident guy.

Jamie Holms:
Well, I love this for a lot of reasons. One is that, I don’t know if you know this, but my nickname is Walnut.

Dr. Andy Roark:
I did not know this.

Jamie Holms:
That is not because I am a tough nut to crack. It is because I have a very tiny bladder and I maybe eat abruptly the size of a walnut. And so I always need to pee. And the moment you-

Dr. Andy Roark:
Do you get excited and pee? Do you pee when you meet new people?

Jamie Holms:
I need to pee when I meet new people. I have better bladder control than Skipper does, but that doesn’t make me a better person.

Dr. Andy Roark:
But you have more confidence, I think.

Jamie Holms:
I have more lived experience than Skipper does, but I definitely, the moment someone is like, your flight is going to board in 15 minutes, I’m like, I got to pee. And then they’re like, the flight is now now boarding, I’m like, I have to pee again.

Dr. Andy Roark:
Yeah, I get that.

Jamie Holms:
It’s just how it is. And so I have a lot of empathy for his situation. But it made me think about confidence and I can think about times when I’m really confident, but that made me go well, when am I really insecure? And so I was thinking about that. And so I wanted to start with the deep question. So Andy Roark, tell me what makes you feel insecure?

Dr. Andy Roark:
Oh boy. What does make me feel insecure? Let’s see. Anytime that I feel like I’m not going to live up to the expectation that people have of me, I get insecure anytime that people are like, I feel like people expect something from me that I’m not going to be able to do, I’m much more worried about letting people down than I am not being able to do the thing, whatever the thing is. And so I am definitely insecure about that and singing. I can’t carry a tune in a bucket, and I am very insecure about singing, but I enjoy it when nobody’s around. But those are my two things. Singing and when people feel like they have expectations of me that I don’t think that I’m going to be able to meet.

Jamie Holms:
So I get a huge gift out of working with you, which is I get to read the articles before anybody else does. And so I was really excited when I read this Measuring Sticks article, which went out in Today’s Veterinary Business, and it’s about how we use all of these, especially in the veterinary profession, all of these things from the outside to judge our self-worth and our confidence. You talk about the SATs and your test scores and how people continue to look for that test to take or that new accreditation to get. And I was thinking about that with this, and I love that you are like, yes, I’m in it. I also get insecure when I think I’m not going to live up to the thing that other people want. And in this article you’re talking about how it’s an internal thing, it’s not the things we get from other people. So I love it that you’re like, yes, I also do this thing.

Dr. Andy Roark:
Well, I absolutely do this. So it’s comparison. It’s the flip side to comparing yourself to other people. And so one of my favorite sayings is comparison is a thief of joy. And I see so many people who are so wildly unhappy because they compare themselves to other people. And I think this is the worst thing about social media, and I think there’s a lot of worst things about social media, but this is probably the worst thing about social media is a lot of social media is geared up about getting us to compare ourselves to other people. And we look. And I don’t think people intentionally mean this to happen, but I think we all know it happens at some level, but people sort of post and I can’t help but look and say, man, their vacation looks better than my vacation. Or, boy, they do a lot of things with their kids more than I do. And oh man, I wish I could have gotten free from work to go to the Christmas event at my kid’s school. And wow, look at the fun Saturday they’re having with their dog.
I barely have time to take my dog out and walk a much less spend half the day at the dog park and then go to a cookout. There’s so much of that. But the counterpart to that, which I think is much more common, is the comparison of ourself to some metric that may not be another person. It’s some belief of what we should be doing or what success should be. And so I’ve talked about Skipper before when I talk about what it means to have a bad dog. And the truth is I say that jokingly. The truth is, if you compare Skipper to, I don’t know, Lassie or you say, boy, a good dog comes immediately when they’re called and they’re always right beside you and they don’t pull on the leash and they would never steal food off the table and they don’t piddle on the floor when people come over, then Skipper’s not a good dog.
But if you reset that measuring stick and you say, “I like I want a fun dog, I want a dog that’s always up for adventures and likes to play and squeaks his toys and runs around and is big and goofy and just genuinely funny and happy to be here,” then he is a good dog. But it’s the measuring stick that you set of what does it mean to be a good dog? And so that’s the basic idea with this. But I started writing this thing because I started looking around it and it was a kind of week that came and went. And I just had all these people around me who were just struggling. And one of them was a vet who was struggling. She didn’t think she was a real vet because she only worked one day a week in the clinic and that was really bothering her.
And there was another vet that was really hacked off because friends from high school were messaging her and asking for advice and she felt like she absolutely had to answer them in that moment at dinner and she was just mad. This is dah, dah, dah. And I asked her, I said, “Why do you do this?” And she’s like, “Well, because that’s what I do.” Basically that’s what it means to be a good vet is you drop what you’re doing and you help people who reach out to you. And I’m like, if that’s exactly how you define being good vet, then you are selecting this measuring tool. I don’t believe that dropping what you’re doing in the middle of dinner to ask pet health questions from people in high school is what it means to be a good vet. I don’t buy that.
But that’s a conscious rejection of that ruler for what it means to be a good vet. And so the same thing is people struggling with their confidence because they were not in the top half of their vet school class. And it’s like, I’m sorry, at what time did we all come together and say, “Hey, you know what constitutes being a good vet? The GPA you graduate with?” I wasn’t at that meeting. And if I was, I would not have voted for that because I was not in the top half of my vet school class. And I don’t think that that defines me as a subpar veterinarian in practice. I just don’t believe it.
Hey guys, I just want to jump in real quick and let you know about some great continuing education I have coming your way. Guys, I’ve partnered with Nationwide to put together a series of webinars that are 100%free to you. They have RACE CE, they are good to go, and they are going to be, first of all just genuinely entertaining and fascinating. The first thing I got coming for you is on November the 14th with my good friend Dr. Emily Tincher. She’s been on the podcast a number of times. I love having her here. She’s such a fun, interesting person who’s a deep thinker. And so anyway, she is doing a webinar called Clinical Empathy: The Exam Room Skill that Can Transform Your Team. I’ve had Emily on the podcast before talking about clinical empathy. This is a really good skill building webinar. This is great for your support staff as well as your doctors, but your team leads especially, but your technicians, your assistants, your CSRs, all of this is just, it’s such a great communication content. I think you’re going to really like it.
So anyway, that is on November the 14th. It is at 3:00 PM Eastern noon Pacific. And then the last one in the series is on December 13th. It is with Dr. Simon Platt. It is called Head Cases, a spectrum of care approach to neurology in general practice. So if you’re a neurology buff, if you like seizures, if you like knowing about seizures, if you like a neurophysical exam, tips, tricks and hacks, things like that, this is going to be a great webinar. So again, this is on December 13th. It’s at 1:00 PM Eastern, that’s 10:00 AM Pacific time. Gang, I would love to see you there. Links to all this stuff in the show notes. Go ahead and grab a spot, I’ll see you there. Let’s get back into this episode.

Jamie Holms:
Yeah. I think that that’s very true and I think we continue to use some of those weird metrics and they made sense when we were using them. One of the things, my dad said this to me the other day, my dad is 81 and I love him very much and he was having an old man moment-

Dr. Andy Roark:
I have those.

Jamie Holms:
… which he readily admitted. And he was like, “Did you know that those people can’t write in cursive?” And I was like, “Who cares?” That’s not a metric. That doesn’t make them a bad person. Why would they need to write in cursive? And he’s like, well, we had to write in cursive. And I’m like, “Dad, people used to hit you with a ruler because you were dyslexic.” And he’s like, yeah, okay, okay, old man moment. But it was funny because he pulled this random metric that doesn’t matter today. And I know there are people out there who believe that there’s a big cursive argument of whether we should be teaching it or not. And I understand how it helps your brain, I get that part. But is it going to help you be a better person later in life? Probably not. It’s the same thing as your clients aren’t asking you, “Hey, what was your GPA when you graduated?” They care more about your empathy and whether or not you bond with their pet and whether or not you think that fluffy is actually cute.

Dr. Andy Roark:
Doctor, can you write in cursive?

Jamie Holms:
Yes, exactly.

Dr. Andy Roark:
I’m going to need to see someone else.

Jamie Holms:
Yeah, exactly. I love that. And so I was thinking about how funny it is that we do pick these things and we measure ourselves. And mine used to be I judged myself on the number of CE hours that I had.

Dr. Andy Roark:
Oh, wow.

Jamie Holms:
And I, you’ll be shocked to know, always had hundreds and hundreds and hundreds of hours of CE.

Dr. Andy Roark:
You had hundreds of hours of CE?

Jamie Holms:
Hundreds of hours because-

Dr. Andy Roark:
I do this for a living and I don’t have hundreds of hours of CE.

Jamie Holms:
Yes, I know. But I would go home and I would take every CE thing that was in every magazine. I would do every free CE that came from IDEXX or from the food company, whoever it was. I would take all of that CE because I was just like, the more that I can show that I know, the more people will value my contribution, which was never true because nobody else ever saw that.

Dr. Andy Roark:
No one asked you how much CE you had.

Jamie Holms:
No, no one.

Dr. Andy Roark:
They said, do you have enough? And you said yes. And they were like, okay. And that was that.

Jamie Holms:
Great. Yeah, that was the end of the story. But I held myself to that expectation. And then as I went farther out of practice and started using my skills differently, I started doing less CE. And I didn’t abandon it entirely, I still more than meet my needs, but I looked at it differently. And if I was still holding myself to that same thing, I don’t know that I could do that anymore. My brain is older, I have less energy. I don’t know about you, but I used to be able to stay all night and work all day and my brain doesn’t do that anymore. So I love that we’re talking about how to find different metrics.
And I think self-worth is one of those. And I think that that’s something we’ve talked about before, how imposter syndrome and our colleagues just, they don’t necessarily have the self-worth. And I love that I have people on our team that I can turn to and be like, hey, can you hold this mirror up for a second because I can’t see myself well right now? And they can help me with that. And I was wondering if you had thoughts about how we help our colleagues find a different stick. You had some great ideas about things to use, but how do we shift this for the community?

Dr. Andy Roark:
Well, I think a lot of it is, I think we all struggle to see ourselves. You know what I mean? I think we all struggle to see ourselves. At some level, I think we all kind of wonder if we’re a good doctor or we wonder if we’re a good technician or whatever. Are we a good communicator? Are we a good boss? I did a podcast just recently with Dr. Natalie Marks and she was talking about perfectionism and being a practice owner. It was just fascinating to listen to her talk about this. And she sort of told the story of having this sort of realization that perfectionism is a manifestation of fear and that it was detrimental in what she was trying to accomplish. And towards the end of the episode, I asked her, “How did you come to this realization?” Because we were talking about the truth of the situation and kind of how to manage that if you have perfectionistic tendencies, but I was struck, how’d you come to realize this?
And she told this great story about being a practice owner and really wanting to be a great boss and then doing 360 degree feedback because that was what you were supposed to do. And she just got hit by a brick when someone was like, you are super intimidating. And it was absolutely, it sort of hammered her and made her short stop and step back. And so I think we all wrestle with that. I think one other piece of this that I want to tie into this before I start talking about what we can do about it, but again, it feels like a related thing is man, there’s so many veterinarians or vet techs looking at things that they want to do or whoever that are just waiting for permission. Is this idea that they need someone to tell them that they can have what they want or they can do what they want or they don’t have to care about this thing. It’s amazing.
It almost like it takes someone to say to them, “Hey, I saw the Google review that you got where someone wrote a one star review of you as a doctor because they called you at the clinic and it was your day off. I see that and I want you to know that’s ridiculous and that’s not your fault and you should ignore that.” And it seems absurd that someone have to give you permission to look at this obviously flawed thing and say that’s not representative of who you are. But I think a lot of us really want to hear that from someone else. And so I think one of the things that we can do for each other as colleagues is to point out what really matters to each other and just say, “Hey, I saw the impact you had on that person and that was amazing. And hey, I want you to know you’re a good friend and a good doctor. And hey, I always appreciate your insight and you’re a great mentor and that means a lot.”
And I think that people get so sucked up into other metrics that are communicated to them, they often forget about that stuff, but we can point that out to each other. I think the biggest thing for me in choosing the measuring sticks that matter is just being aware of the measuring sticks. I think my greatest hope with writing the article, and now we’re talking to you about this, is that people will just stop for just a minute and say, what measuring sticks am I measuring success with? And again, I have chosen so badly so many times in my life and just the process of stopping and evaluating like, wait a second, how am I measuring myself here? I mean, I used to beat myself up because of the number of hours that I worked or didn’t work in the practice, and I would beat myself up as a parent for the number of hours I spent with my kids.
And at some point I had to stop and say, well, wait a second, Andy, is hours in close proximity to your children, is that the measurement that we’re going to use here? Because I don’t know that that’s the best actual measurement of what we’re trying to accomplish. And the same thing the clinic is like, is me just physically being here, does that actually mean anything? I mean, we’re not talking about the number of patients I see. That’s just me being at the building and I feel guilty if I’m not at the building. And I go, this doesn’t make any sense. And so I just think so many of us, we don’t even question the measurements or other people put them on us. So you get called in for your performance review and the manager is like, “Hey, this is the number of pets that you saw in the last quarter and this is your average client transaction. And from those two numbers, I’m going to tell you if you’re a good doctor or not.”
And I’m like, no, you’re not. No, you’re not. You can tell me how many patients I saw and you can tell me what my average clinical transaction was, but I’m sorry, that’s not a two metric equation that makes a good doctor. I’m not saying those things are without value or we should ignore them, but I don’t buy the idea that I’m going to be summed up by those two metrics. Or you going to give those two metrics and say, this is really what matters. Because I’m sorry, I have my own beliefs about what measurements it takes to be a good doctor. And they’re around compassion, they’re around empathy. They’re around taking time to listen. It’s understanding other people. It’s being honest and acting with integrity. It’s being patient and kind. It’s all of those sorts of things. It’s continuing to learn. It’s being a better doctor than I was a year ago.
All of those things are measuring sticks that I’m interested in. I’m not saying anyone is worth any more than the others, but you just have to be really careful, especially if we get into this mindset of the only thing that matters is how many hours I spend at the practice, how much money I make in a quarter, things like that. You go, man, you’re summing way too much up into this one ruler. It’s not that good a ruler. It’s just not.

Jamie Holms:
Yeah, I completely agree with that. And I wanted to shout both preach and say it one more time for the people in the back because I hear so many people in the community talking about how they’re not good at this thing. We have a really good friend who’s a very good manager, and they are in a circumstance where there’s a new gig in town and a whole bunch of people left that practice.

Dr. Andy Roark:
Wow, brutal.

Jamie Holms:
Yeah. And she’s like, I am a bad manager. It’s like that isn’t why people are leaving. They are leaving because there are different hours. They’re leaving because of all of these other things, and you can’t judge yourself on that one thing. There are 10 other things that I know about you and I know about the people who work with you and your compassion and your care for the animals and for the people that work for you and what you do for our community as a whole. And again, when you’re in it, it’s real hard to stop and say, what is my measuring stick? What’s my measurement of success? And knowing that people look at it differently.
And there are things that we can change about how we talk to ourselves. And I think that would be my challenge to our community is to say, hey, when you hear people say, I am not good at this, or I don’t measure up in this way, or I’m not good enough, I challenge you to do what I like to do, which is to say, don’t talk about my friend like that. And I learned that because I had a really bad self-talk. I continued to have a bad self-talk. And so I learned to ask myself the question of would I say that to a friend? And if I wouldn’t say it to a friend, then I don’t get to say it to me.

Dr. Andy Roark:
I like that a lot. I took that from you, and I use that a lot when somebody will be down on themselves and it’s say, “God, I am the worst. I’m such an idiot.” I will say, “Hey, don’t say that about my friend.” And I learned that from you. And so I really do like that as sort of catching some self-talk. One of the other things going back to our person who’s feeling terrible because people are leaving their practice to go work at a new place that’s opening up is, it’s one of those things about picking your rulers again, going back to how are you going to measure yourself? I think we should all be really conscious and cognizant of the idea that we should not be picking ways to measure ourselves that are out of our control. And I see that all the time. You don’t get to control pet owners. Yet I myself would define, I would say, oh, I’m a good vet because I get good Google reviews.
And I’m like, buddy Andy, you are putting your self-worth into the hands of other people and you don’t have the power to make those people happy. There are going to be people who are just not going to like you and there’s nothing you can do about it. And it’s giving them the power to tell you whether or not you’re successful. I think it’s a bad idea. I think if you’re a manager and you set this bar at like, I’m going to have a hundred percent retention rate, no one’s going to leave my practice. I would say, you don’t have the power to keep these people at your practice. You don’t control what other practices can pay. You don’t control what other opportunities come along. You don’t control where other practices open up. Maybe they’re much more convenient to get to. You can’t control if people are just tired and want to change the scenery. You don’t have control over any of those things.
And so using that metric of retaining other people as the definer of whether or not you’re successful, I go, I think that that’s a bad measurement. I think that’s where I’d probably leave this and sum it up is my biggest thing on choosing the measurements that we use for ourselves is one, just to stop and recognize that you’re doing it. Recognizing. Just stop and say, how am I measuring myself here? I feel like I’m failing. What metrics am I using to come to that result? And what are alternative metrics that might be better? And I think it’s 100% on that. And the other part is to stop and say, what metrics are in my control? Am I picking things that I really do not have control over? And if you are, I think you should really rethink those measurements. I think you should go back to the things that you actually have input on.
And so you should decide what it means to be a good parent or a good spouse, not based on what other people think about your relationship, but what you and your partner think on your relationship or you and your kids find meaning in and what you’re going to look back on and be proud of. But it shouldn’t be, Hey, this is what Facebook says parents should do. Forget that that’s noise. But anyway, that’s sort of my thing with the rulers that we choose for ourself. It’s funny. And a lot of us have this ability to cycle through rulers where we measure ourselves this way and we measure ourselves that way and we measure ourselves this way, and none of the ways we choose to measure ourselves are kind. And I just think that that’s sad and that’s silly.
And so it’s something that I definitely picked up in my life is my younger self always chose harsh measurements. And I told myself that was the right thing to do because it was motivating. It was always motivating. But at some point, I don’t need to be motivated like that anymore. You know what I mean? I am, honestly, I’m doing my best. I’m happy with the work that I’m doing and how I’m doing it. I want an honest measurement, not a measurement that’s going to motivate me or terrify me or make me feel guilty so that I work harder or do things that, I don’t know, that I wouldn’t otherwise do.

Jamie Holms:
Yeah, I think that’s a perfect place to end, and I’d like to invite you to come back and talk with me about the art of kindness in an imperfect world.

Dr. Andy Roark:
Oh yeah. Oh, that’s funny. Yeah, The Art of Kindness article is a fun. It dovetails into this-

Jamie Holms:
I think so.

Dr. Andy Roark:
So the thing I want to talk to you about as well, I think I’m writing this piece right now based on what our friend Maria Pirita said to me recently.

Jamie Holms:
Is it, “Who’s Laughing Now?”

Dr. Andy Roark:
No, it was not.

Jamie Holms:
Oh, dang it. That’s a good story.

Dr. Andy Roark:
She does say, who’s laughing now? And that is a great story. I’ll tell a story at some point. But she was basically, we were talking about mindsets, and her mindset is just, it doesn’t seem that hard. That doesn’t seem that hard. And so when you say something to Maria like, oh man, we got to do this surgery. And she’s like, “How hard can it be?” That was the wording. How hard can it be? And I just thought it’s the best mindset you can possibly have is how hard can it be? And I’ve gotten myself into a lot of trouble with how hard can it be? But I’ve also had the best experiences in my life. I’ve also learned more than anything else, I have also just had the most fun, and I’ve also grown as a person when I have thought to myself, how hard can it be? And then I weighed in. So anyway, I think we’ll talk about that in the future.

Jamie Holms:
I can’t wait to read that article. Thanks for having me.

Dr. Andy Roark:
Thanks guys. And that’s it. That’s our episode, guys. I hope you enjoyed it. Thanks to Jamie for coming on. Thanks to Jamie for making the episode happen, because if she hadn’t said, “I really like the article and I’d like to talk to you about it on the podcast,” I don’t think I ever would’ve flipped on the microphone. So anyway, thanks to her for that. Guys, if you enjoy the podcast, it always means the world to me when people leave us an honest review. It’s how people find us. It gives me some feedback on the work that we’re doing, and it means a lot. So anyway, if you have a moment and you enjoy the podcast, please leave me an honest review wherever you get your podcasts, and or share the episodes with your friends. So anyway, guys, that’s all I got. Take care of yourselves, be well. I’ll talk to you later on.