This episode of the Cone of Shame Veterinary Podcast is made possible by Cubex – Protect your people, practice and profits.
Dr. Carrie Jurney, President of Not One More Vet (NOMV) is visiting today to talk about the changes we have seen in the veterinary mental health space during the COVID pandemic. In the last 2 years NOMV has grown radically, and has become one of the most recognizable groups working to improve wellness and mental health in our industry. Carrie and Dr. Andy Roark discuss where mental health initiatives are going, and how they will look very different in years to come.
This episode has been sponsored by Cubex.
LINKS
Uncharted Podcast on iTunes: podcasts.apple.com/us/podcast/the-…st/id1449897688
Charming the Angry Client On-Demand Staff Training: drandyroark.com/on-demand-staff-training/
What’s on my Scrubs?! Card Game: drandyroark.com/training-tools/
Dr. Andy Roark Swag:Â drandyroark.com/shop
All Links:Â linktr.ee/DrAndyRoark
ABOUT OUR GUEST
Dr. Carrie Jurney is a veterinary neurologist in the San Francisco Bay Area and owner of Jurney Veterinary Neurology. When she’s not in the clinic, she’s the president of Not One More Vet, a global mental health support group and charity for veterinary professionals. In her spare time, she is a metal artist, Burning Man Camp lead, and podcaster on the Veterinary Superfriends Podcast.
EPISODE TRANSCRIPT
This podcast transcript is made possible thanks to a generous gift from Banfield Pet Hospital, which is striving to increase accessibility and inclusivity across the veterinary profession. Click here to learn more about Equity, Inclusion & Diversity at Banfield.
Dr. Andy Roark:
Welcome welcome to the Cone of Shame Veterinary podcast. My name is Dr. Andrew Roark and I’ll be your host. I am here today with my friend, the neurologist and president of Not One More Vet, Dr. Carrie Jurney.
Dr. Andy Roark:
We are talking about burnout during the pandemic, the shifting paradigm of wellness in vet medicine and what wellness and vet medicine looks like going forward. What advances have we made in the last couple of years and what advances will we make in the very near future. I’m super happy with the interview as far as how we talk about wellness in a forward thinking progressive action oriented way.
Dr. Andy Roark:
That helps me imagine a better world. That’s what I really like about it. This is a great episode. Carrie and I do touch on suicide. If that is something that you do not want to listen to, then this is a good episode to skip. Otherwise, we just talk briefly about three quarters of the way through the episode. That is what is there. So just be aware of that.
Dr. Andy Roark:
Also, be aware this episode is sponsored by my friends at CUBEX. CUBEX is a maker of DEA compliance smart cabinets that are suitable for any practice size. You can learn more about them at CUBEX.com. Guys, without further ado, let’s get into this episode.
Kelsey Beth Carpenter:
(Singing) This is your show, we’re glad you’re here, we want to help you in your veterinary career, welcome to the Cone of Shame with Dr. Andy Roark.
Dr. Andy Roark:
Welcome to the podcast. Dr. Carrie Jurney, how are you?
Dr. Carrie Jurney:
I’m well, Andy. How are you?
Dr. Andy Roark:
It’s good to have you back. Are we talking about today? Are we doing your neurology wisdom or are we doing your burnout wisdom? I think we’re doing burnout.
Dr. Carrie Jurney:
I think we’re talking about the other stuff. The other stuff. The stuff around practice.
Dr. Andy Roark:
Maybe if people stick around until the end, we’ll do a tight five on the neurologic examination.
Dr. Carrie Jurney:
Hot tips, procedure meds at the end.
Dr. Andy Roark:
Right at the very end, squeeze it in. Oh man. But it’s good to see you. You are a board certified neurologist. You are also the president of Not One More Vet. You had the great fortune to take over Not One More Vet, probably the premier mental health outlet for veterinarians in February of 2020 at the beginning of a global pandemic. Boy, you won the lottery on that one.
Dr. Carrie Jurney:
I really did. I really did. I look back to that board meeting and I think to myself, “My God! My God.” I thought I was like, “Well, I’ve got a big job, but I can do it.” And then we went into lockdown and the world turned crazy.
Dr. Andy Roark:
My last trip was February of 2021. That was the last time that I traveled before a month or so ago.
Dr. Carrie Jurney:
I think we were at the same conference [inaudible 00:03:08] that board meeting at Western. So yeah, I think that’s probably what it was.
Dr. Andy Roark:
That was my last flight and I drove and spoke to some wonderful technicians in Georgia like a week or two after that. I’ll never forget. When we were there, it was weird because other things were shutting down and I remember I called them. I was like, “Are we doing this?” And they were like, “Are you comfortable doing it?”
Dr. Andy Roark:
I was like, “I think so.” But at the point, COVID was moving across the country and it was almost like we were looking out the window and waiting for it to arrive. But it was about the week after that we started having real lockdowns and things. Man. Wow.
Dr. Andy Roark:
Anyway, you take over NOMV. What I want to talk to you today about is the change that we’re seeing in how we talk about mental health and what’s happening in mental health. Have we made any new progress? I think a lot of people go, “Oh my God. Are we doing the same things we were doing years ago over the last few years?”
Dr. Andy Roark:
I go, “I don’t think so.” I’m an optimist. I see progress being made. Let’s go ahead and start to talk about that. You want to talk about burnout in our profession over the last two years? Let’s say between 2020 and now, talk to me a little bit about that.
Dr. Carrie Jurney:
I think there’s so much an important context into realizing that these problems in our profession have been there since we started collecting data. We have data on mental health concerns in veterinary medicine dating back to the 1960s. None of this stuff is new.
Dr. Carrie Jurney:
What I do think that has changed in the last five years and particularly in the last two is that it has been okay to talk about it. And that we are pushing that conversation more and more. Sometimes, that’s uncomfortable. Sometimes that conversation goes a way that somebody’s not entirely pleased about, but at the same time, we are really starting to lean into those hard conversations.
Dr. Carrie Jurney:
Certainly, NOMV is largely run online and so we have those conversations online a lot, but I’m also starting to see them happen in practices and [inaudible 00:05:07] to be a real conversation that is happening around a lot of aspects of practice.
Dr. Carrie Jurney:
And so I think when I look about, look at things like burnout and wellness, I look at them holistically. We always say at NOMV, like suicide prevention isn’t just that conversation that you have. Suicide prevention is also things like financial resources. It’s things like…
Dr. Carrie Jurney:
To get back to your actual question, which was about burnout. How has the last couple of years been? Terrible. Honestly, it’s been a… I’ve worked in veterinary medicine for 20 years. These have been the hardest two years I’ve ever seen for our profession.
Dr. Carrie Jurney:
I think we’re not alone in the world in feeling that it’s been a hard couple of years. But I see the silver linings that I see there. Because I’m not an optimist, Andy. I’ll tell you, but I’ve worked very hard on trying to be one. I see that our profession had some hard changes that it needed to make and this has forced us into some of them. Yeah.
Dr. Andy Roark:
I agree.
Dr. Carrie Jurney:
Yeah.
Dr. Andy Roark:
Let me jump in with my optimism. Here comes the sunshine. Yeah. The pandemic has been hard. I thoroughly and strongly believe that a lot of good has come out of the pandemic for our profession. It’s because we were hammered into making some real changes that we would not otherwise have made.
Dr. Andy Roark:
We talk holistically. Everything from better, smoother communication systems. As far as we’re going to do text messaging and we’re going to do online booking and appointment booking and people go, “That’s not wellness.” I go, “Yeah. It is.” Anything like that that smooths workflow-
Dr. Carrie Jurney:
It super is. I’ve been messing around with telemedicine for like five years and never like made it stick. I figured it out in one day. One day. I’m a single doctor practice, I got COVID and it was like I have employees to support. I’ve got to figure this out today. As soon as my fever broke and I was still at home because it was early on, we didn’t have tests, it was a whole mess.
Dr. Carrie Jurney:
I figured out telemedicine in one day and I still use it to this day. In fact, we do one entire day from home as a veterinary clinic.
Dr. Andy Roark:
Really?
Dr. Carrie Jurney:
It’s amazing. It’s transformational for my practice.
Dr. Andy Roark:
Yeah. I’m sure.
Dr. Carrie Jurney:
My clients love it. My clients love it. All those hard, long conversations, all those really complicated diagnostics, we get on Zoom, we talk, they have focused time. I’m not chasing people on the phone. It’s magical.
Dr. Carrie Jurney:
And so talk about something for burnout and wellness, that’s one day my employees aren’t commuting, that’s one day that we have where I can be wearing my pajama pants. It’s awesome.
Dr. Andy Roark:
No. I completely agree. That’s a fantastic example because you’re right. It’s like, there’s a lot of stuff where we go, “I just don’t want to do this.” And you get kicked in the butt and you’re like, “I can figure this out in a day or two.” Now that the world sort of opens back up, I think a lot of us are using those tools in proportion.
Dr. Andy Roark:
Maybe we’re not using telemedicine all the time like we do. Or curbside, for example. Maybe it’s not all the time, but maybe it’s some of the time and maybe our tiny little vet practice can now see more appointments because we are using outdoor space and there’s all of these things.
Dr. Carrie Jurney:
Maybe you figured out how to check people out remotely. And so now you’ve got a better workflow. I think there’s so much there and I think there’s also a shift in the attitude that needed to happen as well. I certainly have seen amongst practice owners a focus on staff. Realizing that staff is important and staff is precious and they were always important and precious, but I don’t think that attitude was quite as pervasive and I’m glad to see it.
Dr. Carrie Jurney:
I’m glad to see it.
Dr. Andy Roark:
I agree with that.
Dr. Carrie Jurney:
I see wages going up which needed to happen. I think of places like [inaudible 00:08:49] who’ve kind of put it out there of like, “This is what we’re paying.” It brings the status quo to a better place. 95% of technicians don’t make a living wage. So that’s something that we need to address as a profession.
Dr. Carrie Jurney:
I think the pandemic started to push these conversations a little faster.
Dr. Andy Roark:
I completely agree with that. I feel very much that wages in vet medicine, especially for paraprofessionals has not been where they need to be for a long time. And we know that and we talk openly about that. I always hold this up and people look at me and they kind of roll their eyes, but then I think they appreciate that I say it.
Dr. Andy Roark:
I don’t think it’s because veterinarians are bad. I think it’s because they very much want to keep medicine affordable for pet owners and I think veterinarian don’t get paid probably what they’re worth, especially relative to other medical professionals. Absolutely.
Dr. Carrie Jurney:
I 100% agree. I 100% agree.
Dr. Andy Roark:
Again, like there’s no boogieman in this scenario for me, but this is another perfect example of like COVID is good for our profession is that is the kick in the butt where people are like, “Hey, I want to keep my staff.” And now there’s other corporations coming in, there’s a shortage of staff. People are paying more. And I go, “You know what? This is painful. Ouchie! Ouchie!”
Dr. Andy Roark:
It’s good in the long term. I think a lot of people get hung up on like, “That’s not what we’ve paid in the past.” Or, “That’s not what I used to make.” Or things like that. And I go, “That’s not the mindset.” The mindset now needs to be, “How do I make this happen?” That’s the question. How do I do this? How do we go forward?
Dr. Carrie Jurney:
It’s easy to be stagnant until [inaudible 00:10:22] have-to and it became a have-to. I think it’s good. Yeah.
Dr. Andy Roark:
The other have to, for me, it was very much the personal boundary have to. I think there’s a lot of people who just sucked it up. That’s it. Just get it done, just suck it up. I’ll stay late. I’ll put up with the angry clients and blah, blah, blah. I think that having the caseload that we’ve had and people having personal stress at home and people having other things that they have to do, that they didn’t necessarily have to deal with during the pandemic. I think enough people said, “I just can’t suck it up anymore.”
Dr. Carrie Jurney:
It became impossible. It always rode unreasonable. We always achieve… We are an overachieving bunch of squirrels. We really are. But it became impossible.
Dr. Carrie Jurney:
I’ll tell you, Andy. I’m that doctor who doesn’t say no. I’m that doctor, I admit it fully. I admit and I try really hard to like manage that behavior but right now, I’m booked out more than a month and a half and as a neurologist, I typically would never be booked out more than a week.
Dr. Carrie Jurney:
Neurologists [inaudible 00:11:27] emergency have [inaudible 00:11:29]. People are pretty freaked out and I would take emergencies no matter what, and I just can’t do it anymore. We’ve put hard limits on it and it’s still comfy, but I know that it’s what I need to do and I know that I can’t push my staff that way and that I can’t push myself that way. Those boundaries are so important.
Dr. Andy Roark:
I did a lecture today for the first time. It was a virtual lecture in the Netherlands, which is pretty cool. I’m doing this new talk. It’s the first time I ever did it. It’s called practical boundaries for busy practices.
Dr. Andy Roark:
So I started talking about it. One of the big things that I sort of started to put on that is there’s a cognitive sort of distortion that’s called present bias. What present bias is it says that we sort of as a species are wired to favor immediate, smaller gains over later long term gains. Which if you evolve in a resource scarce environment, it makes sense. Eat the berry now even if it might be riper tomorrow, because you don’t know if it’s going to be there tomorrow.
Dr. Andy Roark:
Yeah. And so that’s it. There’s so much of this stuff where we say, we take the thing that’s easy right now and we sacrifice the benefit we could have in the longer term. And so when people say, “Hey, I need to get in. Hey, I need to get seen. Hey, I really want to get in this week.”
Dr. Andy Roark:
There is an immediate benefit to accommodating them because we want to make them happy and we should. It’s funny, the long term benefit in some of those of saying no and saying we are at capacity, that’s harder to see and it comes down the road because you’re like, “Could I get them in? Yeah, I probably could.”
Dr. Andy Roark:
But then there would be more people next week and there’d be more people after that. And at some point, it’s death by a thousand cuts.
Dr. Andy Roark:
But anyway, I just think about that when we say it’s still uncomfortable and it is uncomfortable to say no. You have to believe in the longer term benefit being greater. I think a lot of us, we’re forced to finally go, “Can’t just keep making the short sacrifice. I’ve got to make some changes.” What’s funny is I don’t think many of us are going to go back. I think that once we’ve seen the greater gains down the road of having better boundaries, I think a lot of us are going to keep them.
Dr. Carrie Jurney:
I hope so. I hope so. I also think a lot of us were so busy, are so busy still that we were able to reprioritize the clients that we have a good relationship with and deprioritize the ones we have a bad relationship with.
Dr. Carrie Jurney:
Instead of the squeaky wheel getting all the attention, something that I’ve really noticed in the pandemic is a real focus on I have 300 people that want that appointment. “If you are going to act like this, no, I’m sorry. No, I’m not… I don’t have time to put up with your toddler fit, Ms. Smith. I wish you the best.”
Dr. Carrie Jurney:
I think veterinary professionals on the whole, we’re terrible with boundaries. We all care entirely too much or we wouldn’t even be in this profession. And so that was a really hard one thing. I’ll tell you, I don’t think I’ve even [inaudible 00:14:38] one client a year in my entire career. In the last year, two years, probably five or six. And that’s not a ton given the volume that we’ve seen, but comparatively it is, comparatively it’s like, “Look at that.” Like, no, I’m not actually going to put up with verbal abuse to my staff. Like nope, just not going to happen.
Dr. Andy Roark:
I don’t think there’s a ton of clients that need to be fired, but there’s a couple for most of us. But the thing is that small number take up a wildly disproportionate space in your brain. When you think about clients, you have this wildly out-sized view of the ones that you should be done with.
Dr. Andy Roark:
I think that that’s super important. What do you see as the main differences? When you look through the NOMV lens, what are the differences that you’re seeing now as opposed to at the beginning of the pandemic? Are there different stressors that you’re seeing now that you didn’t see before?
Dr. Carrie Jurney:
I think there’s a change in attitude. I think everybody was in emergency mode for a really, really long time. Me included. I actually really love emergency mode. It is kind of where I thrive. Neurochemically, I have ADHD. My brain is always seeking adrenaline, always, always, always. I just really enjoy that space. It’s exciting.
Dr. Carrie Jurney:
I remember I was talking to our mutual friend, Bruce, about… He set up a war room in his practice where they would strategize new things every day. And I was like it’s exciting. It’s exciting. But as the months rolled on, you can’t stay there forever and you have to adapt. I think what I’ve noticed in the last probably… Probably six months ago, we really started to reach true exhaustion.
Dr. Carrie Jurney:
People just truly, truly exhausted. Now, what I’m starting to see is adaptation. Like people adjusting to the new normal. People taking the lessons they’ve learned and really trying to find something sustainable. Not everybody’s there yet. Even in my practice, I don’t know that we found what truly sustainable feels like, but we are so much closer than we were six months ago.
Dr. Carrie Jurney:
We’ve already come to grips to the fact we need to have these boundaries. We’ve already worked out all these technologic systems and now, we’re in the refining point of like, okay. All of this was great stuff that we’ve learned. I do feel like I’ve put enough boundaries in place and I’m starting to take a breath and say like, “Okay. How do we move on from here?”
Dr. Carrie Jurney:
I’m excited for that. I think that that’s going to be a place of extreme growth. I truly really think that the pandemic will have forced a paradigm shift in veterinary medicine. It was a long time coming. We needed something dramatic to kind of kick us in the butt and here we have it.
Dr. Andy Roark:
Yeah. Well, let’s push through into some specifics here. What do you see? Because you and I keep talking about, yeah, boundaries are better and we’ve got better boundaries. What specific boundaries are you seeing that you think are having a positive effect?
Dr. Carrie Jurney:
People started going home on time. I think that one’s huge. I think that’s one that we let slip a little too often in our profession. We take that one more case. We just stay a little bit later. We’ve got to stay to make those phone calls. It’s just not happening as much anymore.
Dr. Carrie Jurney:
I think sort of the wonderful but slightly unrealistic expectations we’ve put on ourselves for customer service. Like I don’t know about you, but my personal doctor has never called me back same day with my blood work results.
Dr. Carrie Jurney:
Especially ones that were not critical like life threatening type things. I see a lot of people saying like, “Yeah, it’s going to be a few days. You might get an email, you might talk to a technician.” Those sorts of things that we’re always okay but we, as a culture didn’t really do are now okay.
Dr. Andy Roark:
Yeah. I’ve gotten good at saying two to three days. “So I’ll have some blood work back for you in two to three days.” Do you know how many people get when you tell them it’ll be two to three days? None. Not one. Nobody cares. But then they’re thrilled when I call them the next day, because things are good.
Dr. Carrie Jurney:
That’s right. That’s right. I try to set up everyone who like, “Hey, if it’s easy, this is what we’re going to do and you’re going to hear from the technician. If we need to talk more, I’ll give you a call.” And if we need to talk more, we set up a telemedicine appointment and we only do those on Thursdays. So like, “Hey, the doctor wants some in-depth time with you. We’ve set 20 minutes aside on Thursday for you guys to have a Zoom, so you can really dig in.” They love it. They love it.
Dr. Carrie Jurney:
Sometimes that means people are waiting five days for results, which I think three years ago, that would’ve given me like heartburn. But yeah, that’s just what it is.
Dr. Andy Roark:
As I’ve gotten older, I’ve had more interactions with human medicine and I can tell you that nobody’s rushing to call me the next morning about anything.
Dr. Andy Roark:
I don’t think that it’s a wild concept to people. I was goofing around with some numbers when I was putting that practical boundaries talk together. I was like, it’s funny. There’s all these things that we do or that we don’t do and we have these sort of systems where we don’t really have good boundaries towards the end of the day or we don’t have good processes for getting people done at the practice and out the door.
Dr. Andy Roark:
I was like let’s just say that there’s something that we do that’s not super efficient. When it kind of goes wrong or when we take that extra appointment or whatever, let’s just say that the team stays seven minutes late. Seven minutes, not a big deal. But let’s say it happens like three times a week.
Dr. Andy Roark:
Three days a week, we stay an extra seven minutes. I’m like, that’s nothing. We go well, that’s 20 minutes a week, X 50 weeks a year is a 1,000 minutes. That’s 17 hours out of the year that you spent just not quite getting done and getting out. That’s 170 hours in 10 years. 300 and some hours in a 20 year career.
Dr. Andy Roark:
Again, I’m not trying to split hairs but that stuff matters and we’ve just always kind of been [inaudible 00:20:31] about what’s a 10 minute break every day? That’s that’s 50 minutes a week X 50 weeks. You do the math. That’s rest time. That’s time for you just to detach and get your head straight and come back to work.
Dr. Carrie Jurney:
Yeah. No, absolutely. I think that those little moments they were on us, they wear on our staff, there’s a lot of great work that’s come out on burnout and technicians in the last year and predictability and control of our scale was one of the main ways that you could protect against burnout in your technical staff. Doesn’t that just speak volumes?
Dr. Andy Roark:
Yeah. I have been blown away by the lack of predictability in scheduling in our profession. I don’t think I really realized until the last year or two, how many technicians don’t know what their schedule’s going to be next week. They’re like, “I don’t know what I’d do next week.” And I go, “That’s a real hard way to live.”
Dr. Carrie Jurney:
How do you live life? How do you live life as an adult, not knowing can I have a hair appointment next week? Come on, a dentist appointment, anything. I have come so much further with retaining staff and having happy staff and having a happy practice by making sure every one of my staff members gets treated like a grown up with important things in their life that aren’t work.
Dr. Carrie Jurney:
One of my techs who’s been with me for 10 years that I love to pieces, [Evie 00:22:00] is great, she told me during her review, we’re talking about goals, where she wanted to go. She’s like, “I honestly just appreciate that you let me be a mom too.” Like, I don’t care if she’s on the front, her kid calls her from home like he’s doing Zoom class and he needs… I don’t care. Go take your call. We can wait five minutes for you. That means I get this great RVT who otherwise just would’ve left the workforce.
Dr. Andy Roark:
Yeah.
Dr. Carrie Jurney:
One of my other RVTs came to work for me. The job she was at previously told her that she absolutely had to be on call on Saturdays. There was no other option. She takes care of her disabled mother on Saturdays. That’s her day in the family to do it. She can’t do that.
Dr. Carrie Jurney:
Just by saying like, “Okay. No. That’s something I can work with.” That level, it’s the level of respect that I want. Sending that to everybody, gosh, everybody just wants to be treated well like they’re a human being.
Dr. Andy Roark:
Yeah. Oh yeah. Yeah. I think that’s true. It’s been interesting watching some of the boundaries that I’ve seen practices put in place. At first all kind of look a little sideways at them and then later on, as I hear more feedback about these things, I’m kind of impressed.
Dr. Andy Roark:
I’ll give you an example. Enforcing breaks. When I first heard of practices being like, “We enforce breaks. Not only do we give you time to take breaks, but we are going to make you… You have to take them.” I was like, “I don’t like that.” As someone who doesn’t like to be told what to do, I don’t like that.
Dr. Carrie Jurney:
I will tell you that lunch is legally mandated in California. I live in the great state of California where we have a law for everything. When I moved here, that was the one that I was like, “Are you kidding? Come on.” This is medicine. And really, we’re going to legally enforce this?
Dr. Carrie Jurney:
But I will tell you, I never had a lunch break in veterinary medicine until it was legally required. It wasn’t legally required for the doctors, but you saw the techs doing it. And you were like, “Well, maybe I can too.”
Dr. Andy Roark:
Well, yeah. I don’t have any help. I might as well just sit down and eat lunch.
Dr. Carrie Jurney:
[inaudible 00:23:58] I’ve got no one to help me, so I guess I’m going to go eat. That’s huge. That’s huge. It feels Draconian at first, but then you realize that we’re fighting against a big cultural push. We’re fighting against a cultural push, not to do it. Sometimes you’ve got to fight back.
Dr. Andy Roark:
I agree with that. I think that’s a big part of this, fighting the cultural push. The other thing that kind of blew my mind and where I sort came around on this is work ethic is one of my core values. I believe that to work hard. I think that that’s just part of what it means to be a good person is you work hard.
Dr. Andy Roark:
That’s a 100% how I was raised. When we say, “Hey, techs. You guys can take lunch break and here is the time to do it.” I’ve seen a lot of practices that will say, “Yep, you have this time to do it.” Meanwhile, I’m going to keep working over here just so you know, I’ll be working and you go, oh, now you’re laying this guilt on them.
Dr. Andy Roark:
And the other thing is there are other people who go, “You know what? You guys go ahead and lunch. I’ll stay here and help.” And those people get ahead and the work ethic part of me goes, they should get ahead because they’re there and they’re working there putting the time. And I go, yes, but if you flip this around, if I reward someone for staying and working, that’s the exact same thing as me penalizing other people for not staying and working.
Dr. Andy Roark:
And now I am penalizing people for taking lunch by allowing other people to stay through lunch and gain favor, gain opportunities, gain experience, gain knowledge. I kind of had to roll that around in my mind a bit before I was like okay. I’m on board with saying, “You know what? Everyone goes to lunch. That’s what we do.”
Dr. Carrie Jurney:
Yeah. No, I agree. I think the more that we… Be the change you want to see in the world. As I started to talk about wellbeing and started to collect data and statistics on things like… I mean, we were talking about lunch.
Dr. Carrie Jurney:
When I did the poll three years ago, 75% of veterinarians didn’t regularly take lunch. 75%. Oh my God! Guess what? I was one of them. Like, I’m doing the poll, I’m giving the lecture. And I was like, “That’s really hypocritical of me to be talking about this and not doing it. I think that these changes, they aren’t impossible, but they do take some neurons.
Dr. Carrie Jurney:
You’ve got to say to yourself, “No, as much as I feel like I should sit here and make phone calls for the next half hour, I’m actually going to go walk to Starbucks.” And that’s just what you got to do.
Dr. Carrie Jurney:
What I have learned is I am a better, more efficient, more focused doctor when I take those 10, 15, 30 minutes and you come back refreshed, you come back, you work faster. You don’t lose time. I think a lot of people think like, “Oh gosh. Well, I’m never going to get on home on time if I don’t do that.” Actually you will. You’ll just be more efficient when you get back because your brain will be exhausted.
Dr. Andy Roark:
Yeah. I agree. What do you see going forward as far as changes that we can anticipate in practices? What do you think people are getting on board with? What do you see five years down the road that you think is going to be more normal than is now?
Dr. Carrie Jurney:
I hope very much that we continue to be creative with how we run our practices. We came up with curbside medicine collectively as a profession in two days and I think perfected it over two months. That means there’s tremendous room for creativity. There’s tremendous room for innovation. I know and you know, I think our profession on the whole tends to be a little bit stagnant.
Dr. Carrie Jurney:
We tend to be like, “This is the way we used to do it.” I think about how many times I have to use the fax machine every single day and it’s 2021 for God’s sake.
Dr. Carrie Jurney:
I’m very much hoping that we keep this creative energy and we keep this… I think I will probably always do a little bit of curbside. Some of my clients really, really like it. My clients are busy professionals. They need to be taking a call in the car. They don’t want to be sitting in the vet. Drop off appointments, we’ve done a lot of those too.
Dr. Carrie Jurney:
We’ve just gotten more creative with systems and I hope that continues. I deeply, deeply, deeply hope that we continue to appreciate our staff and push for fair and equal work practices, push for excellent benefits, excellent pay for everybody. There’s a shortage of vets, there’s a shortage of techs. Let’s make our profession attractive again.
Dr. Carrie Jurney:
Not just because everyone wants to help dogs and cats and horses. Of course, but also because it’s a great job because it’s a great job where you not only feel fulfilled from your career, but are also like rewarded in all the other ways that being adult takes. Yeah. So you have health insurance, stuff like that.
Dr. Andy Roark:
Yeah. I hope we keep adding wellness resources and lifelines and that they can be very practical and pragmatic and fit into small businesses really well. I’m a big fan of EAPs, Employee Assistance Programs, things like that so that…
Dr. Andy Roark:
I don’t buy into the idea of people should have personal boundaries and we should tell our employees that they matter, but we don’t really support them or we don’t really have anything for them. And at the same time, I also think, I think this is really important, as we talk about mental health and we normalize talking about mental health, veterinarians are not therapists and they should not be therapists and they should not act like therapists.
Dr. Andy Roark:
I don’t want to be a therapist for my employees or my technicians or my staff or whoever. That’s not what I’m good at. And that’s not what I’m for. That’s not stress that I want to carry.
Dr. Carrie Jurney:
Well, I think there’s a really interesting intersection between peer support, which is clearly something that NOMV was built upon and so I feel very strongly about and mental health. Peer support is not a replacement for mental health and mental health is not a replacement for peer support and both have their spaces and their time and the way that they work together.
Dr. Carrie Jurney:
Talking about resources, EAPs are great. They’re under-utilized. 17% of practices have them, only 14% of employees use them when they exist. That’s a great resource that just isn’t getting traction for some reason. That’s something we could do better at. Absolutely. I could certainly speak to what my organization is doing. We have a couple of really big programs coming out soon.
Dr. Carrie Jurney:
We have a new program called Lifeboat, which is going to soft launch hopefully next week because we realized that a lot of people needed peer support and Facebook wasn’t a good place for it either.
Dr. Carrie Jurney:
They didn’t want to be a member of Facebook. Facebook isn’t private and it’s never going to be private. We made a completely anonymous online support service, where we match you with three trained volunteers. These guys get pretty intense training. They do a lot of training and in the background, they have mental health care workers as support.
Dr. Carrie Jurney:
They have people that they can ask questions who are suggesting resources. But I’m really excited about that environment because not every person out there wants be peer support or is even appropriate to be peer support. We want to provide that for them. And then the other thing we’re making is something called Clear Blueprint, which is a new program where we don’t want to just make a practice certification.
Dr. Carrie Jurney:
Those things often end up just being box checks that people do, but what we’re doing as we’re going to practices and we’ve developed this with lawyers and psychiatrists and a bunch of professionals and we’re giving kind of like some evaluations. We give evaluations to the practice. We take anonymous surveys, we observe and then we, we see where that practice is actually struggling as far as wellness goes and then provide targeted resources around that.
Dr. Carrie Jurney:
It’s great to say like, “Go take a wellness class. Go take a professional development class.” But maybe it’s not the one you actually need right now. It can be hard. You can lose the forest for the trees. I’m hoping that these two programs particularly together provide like a big leg up and everybody who owns a practice wants their workplace to be a happy place..
Dr. Carrie Jurney:
Nobody goes into practice and be like, “I’d love to have a really toxic, horrible environment. Can we just get that going?” Like that’s not real life, but it’s can be really ephemeral and like how do I get there? What do I do? Pizza parties are not doing it. Where do I go next?
Dr. Carrie Jurney:
I’m hopeful that we can really… Instead of just saying like, “Wellness is really important.” Like what? What is important? And really start to drill down and it’s going to be different for everybody which is why I love how Claire is approaching it.
Dr. Andy Roark:
No. I like that as well. I think my point is for sure is most of us are here running vet hospitals. That is our interest and it’s what we’re good at and it’s what we know. We want our people, our colleagues to have support and get support and we ourselves may not know how to give it. We may have reservations about getting it. We don’t have time to give it.
Dr. Andy Roark:
I think it’s really important for practices to have those types of outlets and be able to direct people to those types of resources. Yeah, somethings like things places where our staff can get counseling just exactly what we’re talking about, whether it’s peer counseling or one-on-one counseling, things like that, virtual counseling, the assistance programs I think are really good.
Dr. Andy Roark:
I put drug restriction into that category as well as a resource also. When we look at depression, suicide, things like that and we look at deaths of despair in our country, which have gone steadily up, especially during the pandemic, we’re talking about opioid abuse, we’re talking about suicide, we’re talking about drug overdoses, things like that.
Dr. Andy Roark:
I really think that drug restriction is important. I think that our profession is still way behind probably where we need to be, but I see a lot of movement in that direction. I see places getting much more serious about how they control their drugs. [inaudible 00:33:59] Use that to keep their employees safe, whether it’s from addiction or overdose or things like that.
Dr. Carrie Jurney:
No, I agree. I agree. I think restriction to access to drugs is always something that kind of ruffles some feathers. Especially when you, you do it in the lens of mental health because it doesn’t feel good. It doesn’t feel as nice as, “We’re going to get you a counselor. We care about you. We’re going to give you the day off.”
Dr. Carrie Jurney:
It’s not a fuzzy thing and truthfully, it doesn’t fix the underlying problem. Like whatever’s happening, it doesn’t fix the underlying problem and that’s why it doesn’t feel satisfying. But that doesn’t mean it’s not important. Specifically along the lens of suicide, unfortunately data has shown that the primary way that veterinarians die by suicide is Pentobarbital poisoning in the United States.
Dr. Carrie Jurney:
Opioid poisoning is very high for our veterinary technicians. And so just from a very practical standpoint, that’s something we need to address. Across suicide prevention, no matter what lens you’re talking about, across suicide prevention, preventing access to means of suicide is one of the primary ways that we intervene in the acute phase.
Dr. Carrie Jurney:
Every everywhere it’s done, it gets pushed back. I remember when they put the nets, I live in San Francisco, unfortunately the Golden Gate Bridge used to be one of the top places in the world for people to die by suicide. That’s really not something you want [inaudible 00:35:24]-
Dr. Andy Roark:
Yeah, that doesn’t go on the pamphlet.
Dr. Carrie Jurney:
It’s not a Postcard. The Park Rangers who take care of the Golden Gate Bridge have done a lot of things. There are phones that you get directly connected to a crisis line every 20 feet on the Golden Gate Bridge. A couple of years ago, they put up nets and the nets were really expensive, really expensive. Of course, it was another tax on your registration and et cetera, et cetera.
Dr. Carrie Jurney:
People kind of rattled their fist at them, but it worked. I think that some of the solutions to wellness issues, like we were talking about in the beginning, they’re not… Suicide prevention, isn’t just crisis lines and mental health days. It’s wages, it’s prevention of access to means, it’s a lot of different things.
Dr. Carrie Jurney:
I know my own practice, right now we share space with an emergency hospital and very recently, they went from the cabinet with the key that was off always on the counter and sometimes was… It was supposed to not be on the counter, but it was on the counter or in the lock. That system and they got a CUBEX. Even just time-wise from like a paperwork perspective-
Dr. Andy Roark:
That’s becoming a bigger and bigger deal. Honestly, the amount of logging and paperwork had to keep up with for our control drugs, especially if you’re carrying the heavy stuff, it’s getting more and more. That’s a quiet advantage of just having all electronically done and you’re like, “Here’s our log. It already finished. I didn’t touch it.”
Dr. Carrie Jurney:
As a practice owner, those things are on investment. CUBEX is an investment.
Dr. Andy Roark:
Oh yeah.
Dr. Carrie Jurney:
And you start to, of course it’s important, of course wellness is important. But there’s always other things to think about and staff time and logging all that stuff-
Dr. Andy Roark:
Well, even around to your first point too of… I really like thinking of wellness this way as this massively multimodal thing and say, “Decreasing employee workload is a wellness program.” It’s sort of like, if I can outsource my inventory management to a drug box.
Dr. Carrie Jurney:
No one likes menial task. Come on.
Dr. Andy Roark:
Yeah.
Dr. Carrie Jurney:
Nobody likes. Yeah.
Dr. Andy Roark:
Yeah. But yeah, I just… I think that’s the point where I want to leave it today. I think the struggle is real and we all know that, but guys, I think that there’s a lot of things that we are doing. I think we’re getting some things right. I think things are better than… I think things are better than they were a few years ago for a lot of us, as far as our boundaries and honestly, the way that practices are looking at staff, I see paraprofessional wages going up and that makes me feel good.
Dr. Andy Roark:
I see better boundaries of people saying, “We’re going home and we’re taking lunch.” That makes my heart feel good. I think that a lot of us are figuring out ways to be more efficient. I love to use the word precious. Our staff is precious and I go, “Yeah, I think that’s true.” I think the paradigm shift of we take care of our staff and they’ll take care of our clients beats the hell out of we’ll take care of clients and hope our staff is okay.
Dr. Andy Roark:
I think a lot of us have gone through that and I think that’s really good.
Dr. Carrie Jurney:
Yeah. Let’s stop trauma bonding.
Dr. Andy Roark:
Yes. I love that. I love that phrase, trauma bonding. Let’s definitely… There’s no suffering award that we want to win. And so let’s not do that.
Dr. Carrie Jurney:
This is not the struggle Olympics. You do not need some medal. We can make the profession something. There’s a really great quote about self-care that I always think about. True self care is building a life you don’t need to run away from.
Dr. Carrie Jurney:
That’s just so powerful. But that takes focus. It takes forethought. It takes doing the stuff that’s not fun in the moment, but it’s so, so important. All of this stuff kind of falls into that category for me, but it’s worth it. Super worth it.
Dr. Andy Roark:
Yeah. Carrie Jurney, can people more about NOMV? Where can they find you? Yeah. Where can they read more?
Dr. Carrie Jurney:
Well, you can always visit nomv.org, N-O-M-V.O-R-G, we are always looking for donations, we’re always looking for volunteers. You can learn about all of our great programs.
Dr. Carrie Jurney:
I would be remissed if I didn’t mention that our good friends at CUBEX are actually about to run a charity auction for us. They are going to auction off a one year deluxe subscription to the CUBEX MiniPlus and that’s what we use at my hospital. It handles all the things. It’s great.
Dr. Carrie Jurney:
There’s going to be two winners. There’s going to be kind of a random draw as well as the highest bidder is going to win and they’re donating all proceeds to NOMV.
Dr. Carrie Jurney:
CUBEX has been really awesome to NOMV actually. They’ve been supporting us for quite a while and we super appreciate them. And then you can always find NOMV on social media. We’re on Instagram, we’re on Facebook, we’re around. Reach out if you need help. We’re here.
Dr. Andy Roark:
Awesome. Thanks for being here.
Dr. Carrie Jurney:
My pleasure.
Dr. Andy Roark:Guys, that’s our episode. That’s what I got for you. I hope you enjoyed, I hope you got a lot out of it. If you’re interested in CUBEX and learning more about their inventory control systems and DEA compliance storage cabinets, check out cubex.com. I’ll put a link down those show notes. Guys, take care of yourselves. Be well, I’ll talk to you soon. Bye.
Editor: Dustin Bays
www.baysbrass.com
@Bays4Bays Twitter/Instagram
