Dr. Andy Roark takes more questions from the mailbag!
Questions in this episode:
How involved should associate veterinarians be with boarding in the clinic?
Phone etiquette when trying to help non-clients on the phone who need assistance but they can’t be seen due to lack of appointment availability
What are the best things to do for your staff on one of those crazy days when everything is on fire to keep them motivated ?
What’s the best thing to do when you’re feeling overwhelmed?
What advice would you give those that have trouble making boundaries at work?
How do you bridge the gap between “front and back”?
How do you coach someone that gives very blunt delivery of feedback and rubs people the wrong way?
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Dr. Andy Roark:
Welcome everybody to The Cone of Shame Veterinary Podcast. I am your host, Dr. Andy Roark. Guys, I’m back experimenting. This is Part 2 of my recent experiment of live streaming the podcast into the Uncharted community and so, I got questions from the Uncharted Veterinary community. If you’re not familiar with those guys, you can check them out at unchartedvet.com. It is where I spend a lot of time hanging out talking about leadership and communication and management and stuff like that that I love. But anyway, I’m here with these guys and just going to go through questions that I got from them and that will be it, so let’s see.
Yeah, I’d love to hear your feedback on this podcast. If you like it, you can send me an email at firstname.lastname@example.org. You can also leave me a review wherever you get your podcast. But I really haven’t decided if I’m going to do more episodes like this. I’m really kind of waiting to see if people tell me that they like them and I can tell you, I really enjoyed the first one, so this has been really fun.
If you’re listening and you’re like, “Man, these questions where Andy is just talking through problems that people ask him about, I really, really love them,” I have another podcast, it’s called Uncharted Veterinary Podcast and I do it with my friend, practice management goddess, Stephanie Goss. And that’s all we do there, is breakdown questions about practice that people ask us. So, if you really love this, no matter what, you can have more of me talking about problems at the Uncharted Veterinary Podcast, which is the other podcast that I do. All right, let me go ahead and 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:
All right, everybody. So, the first question is an anonymous question. This is from a veterinarian. She is a veterinarian that has a boarding facility built onto her practice and she says that, a little backstory, she had a dog that had a medical problem. It was some sort of like a chemical burn or something when it left the boarding facility. She ended up looking at it and then the client ended up bashing the boarding facility and specifically, this vet who’s like, “I didn’t do any… I didn’t have any idea what was happening,” is basically it.
And so her question is, if a dog is being boarded with a vet clinic, how involved are veterinarians in the daily care and monitoring of the pet? If I’m unhappy of the vet with the care that a dog received and don’t think the issue was handled appropriately when I brought it up to the practice manager, how should that be handled? Meaning, if I don’t like how this went and I said so to the management and they ignored me, what do I do about it?
All right, cool. Let’s do the first one first and let’s talk about the boarding, that’s in boarding, okay? How involved should vets be in the boarding that the clinic does? First of all for me, I guess, there’s not a right answer. There’s only clear expectations and so, there are clinics that the vets are very involved. That’s not wrong. And there are clinics where the vets are not involved at all. They’re barely aware that the boarding is happening in the building. That’s not wrong either.
As long as everybody is clear and honest about what is happening and how involved the vet is or how involved the vet is not, the pet owners should not think that their pets are being examined twice a day by the veterinarian if that’s not happening at all. That’s only setting the vets up to get hammered. They aren’t doing anything. And at the same time, if the pet owners think they’re just dropping off for boarding and their pet ends up doing a bunch of medical stuff and then they’re surprised when they come back and find that out, that’s also really bad.
And so, it’s really about what are the expectations here about how involved the vets are with what’s happening ? Ad is the clinic communicating that to the clients and do they communicate that to the vets? Because I will tell you that boarding can burn vets up. I have seen vets that are absolutely ready to mutiny over boarding because they’re like, “This never ends.” And I’ve worked at some of those practices. It’s never real bad, but I can definitely see how it gets bad.
But it’s just there’s times that you’re a vet and just the number of little problems, torn toenails, diarrhea, coughing dogs, kennel cough, people coming back with kennel cough, things like that, it can suck up your time and suck up your time and suck up your time. And if you are the doctor and that’s not accounted for in your schedule if you’re not getting compensated for that, if these are no charge appointments because the pet started coughing on boarding and things like that, if that hasn’t been discussed with the veterinarians, they can get really resentful and it’s not hard to see why.
At the same time, if boarding is part of what your clinic does and you want to be a good team member, you got to support the team. And so, there is a part where you say, “Hey, we should all be supportive of what the practice is doing to pay our paychecks and to serve the community.” And so, it really, it’s a give and take and that’s why I said there’s not a right answer. There’s clear communication. There’s clear expectations. If you are working in a practice and this goes to the second part where she says, “What do I do when this wasn’t heard?” Talk about it.
If you’re a vet and you’re like, “This is eating me up and this is taking so much time and it’s really frustrating, “you need to have that conversation. And not in like an, “I’m angry way,” but in a, “Hey, we’re in a relationship together and part of the relationship is knowing where the other person is. And so, I want to let you know that this is kind of where I am. And I’m not resentful, but I can see resentful from here. It’s just kind of over the hill.” I think you should say that.
And my question is always what is kind? Do the kind thing? It’s not kind to keep your mouth shut until you’re really, really angry and then blow up on the practice that you work at. And if you’re the practice, it’s not kind to keep your mouth shut and go, “Well, maybe she won’t notice how much work she’s doing.” And just hope that it all works out and the other person doesn’t notice that they’re dealing with a lot of cases from the back. So, anyway, there can be some real drama with boarding.
That’s just my thing is clear expectations, clear communication to the client and between the practice and the doctors. If the doctors are expected to contribute to the boarding, you just need to talk that through and everybody needs to be okay. No surprises. And as long as it works for everybody, I think that’s the best thing. I think that’s the best that we can do.
All right. I got a question Kyle Ann. She says, “Do you have tips on phone etiquette when trying to help non-clients on the phone who need assistance, but they can’t be seen due to a lack of appointment availability?”
Okay. I think a lot of us are dealing with this, so we have people on the phone and we can’t get them in and that is a problem. Now, I would say this writer makes this pretty easy for me because she says non-clients. And so, this is not a person that has been coming here, this is not a long-term client. What do you do in helping this person who needs assistance, but we can’t get them in? I just said clear is kind and I go back to it. Clear is kind.
I said, what is kind? Clear is kind. That’s what is kind. Clear is kind. We need to tell people that we don’t have availability and don’t beat around the bush, don’t act like, “I don’t know. Maybe we can do this or maybe we can do that.” And I understand. We don’t like to tell people things that they don’t want to hear. And so, it is hard to say to someone, “I’m sorry. We can’t get you in.” Clear is kind.
Set expectations and the expectation is “I can’t get you in.” The longer you wait to say that, the more you’re going to frustrate this person. And so, the first thing is be honest, be clear, and then be polite and be firm. And I think a lot of us really struggle with this and we end up, we cave. We fold like origami. We’re like, “I don’t have any availability but I don’t want to tell this person they can’t be seated, so I’m just going to through strength of will make this happen.” And I go, “That’s ridiculous.”
I’m talking a lot these days about capacity and teams and if your team is working as hard as they can work every day and they’re burning out, you can’t just want to do more work and make it happen. You’re pushing your team into the red and there’s going to be consequences. And there are going to be possibly your staff leaving and then you’re more shorthanded. And so, by pushing this far, you’ve limited your ability to do work for the foreseeable future because it’s the hard hire. And so, you have pushed this to a point that you have damaged your long-term potential to do good in the world by trying to squeeze in this short-term thing.
The other thing is even if they don’t leave, you burn these people out. You end up with just people who are tired. They’re grumpy, they’re angry, your practice culture suffers. You are running a sprint every day and that’s ridiculous because this is a marathon and so, pace yourself for a marathon. And you just have to be honest about what your team can do. And then here’s the thing, you got to let it go. You’ve got to process your lack of responsibility here.
One of the big things for me is, look, if there’s something and I didn’t want it, I don’t have control over it. I can’t make it stop and I don’t benefit from it, I’ve got to step back and say, “I’m not responsible for this.” And that’s the case with our overwhelm a lot of these practices. “I don’t want this, I didn’t make it happen. I can’t fix it and I don’t benefit from it because my people are burning out. It doesn’t help me to turn people away. That’s not helpful.” And so, at some point I have to say, “Well, if all those things are true then I’m not going to hold myself responsible and beat myself up about it.”
I hear from practices that are like, “Our front desk just apologizes all day long.” I’m like, “You have to stop. That’s not healthy.” It’s not healthy for practices to be on the phone apologizing all day long. It is what it is. I didn’t want this to be the case. The honest truth is we’re not taking new clients. Just say it and be kind and be firm. And then facilitate this person getting seen somewhere else. And that doesn’t mean you have to call and try to get them an appointment, give them a recommendation. If you can’t see them then tell them if you were them, where would you go?
And this idea that we don’t refer to other general practices, that’s ridiculous. That doesn’t make any sense. That is pennywise and dollar foolish. We are trying to do good in the world. We’ve got more business than we can do. Take care of the people who come to your practice and help other people get seen elsewhere. And feel good about yourself and go on with your life and stop burning yourself out and burning other people out.
Hang up the phone. Practice saying no by saying yes. And so, this is the one piece of phone etiquette is be clear. “We cannot do this. We are not doing this. I have some recommended practices you can call who do good work,” and say it. Don’t tell people what you can’t do for them any more than you have to. Tell them what you can do. When they say, “I need to get in,” we’ll say, “I can get you in. It’s going to be in January,” to get in to start a new client relationship here. And that’s not saying, “No, I can’t see you.” It’s saying, “I can see you in January.”
And if they want to do that, they can, that’s fine. If they say, “I can’t do that,” and you say, “Great. Well, I can refer you to another vet practice?” And I’m trying to tell you what I can do for you, but ultimately I’m not going to waiver. These are the boundaries. And so, I know that we struggle a lot with the desire to get people in and help people and I know that it feels awful to send people away. These are things that we have to do right now, guys.
It really is a question of do you want to do a good job today or do you want to do a good job in your career? Because if you “do a good job” by squeezing everybody in today, you’re not going to do a good job in your career because you’re going to be short-staffed, and you’re going to be burned out and you’re going to be angry and you may end up depressed. And so anyway, that’s my thing. Clear is kind. Be honest. Facilitate them as best you can in getting seen and that doesn’t have to be at your practice. And tell them what you can do as opposed to just focusing on what you can’t do.
Jodi asked, “What are the best things to do for your staff on one of those crazy days when everything is on fire to keep them motivated?” I’m getting a lot of questions like this. “How do we keep morale up? How do I keep people motivated? How do I make people feel appreciated?” I love this question. Here’s the answer. I have no idea. I have no idea. Here’s why because I don’t know your staff and every staff is different and that’s not good or bad, it’s just the truth of the matter.
And so, you say, “What are the best things to do for your staff on those crazy days?” My advice to you is ask the staff. Ask them what they want. Ask them what makes them feel good on those crazy days. Now, you have to ask it in a certain way because what I’ve found is if I go to the staff and I say, “Guys, when we are crazy like this, what would make you feel better?” They have no idea.
And of course, they don’t because if I came to you and you had a really bad day and I was like, “What would make you feel better?” You’re like, “I don’t know.” The truth is ask them and ask them when things are not on fire. So, at the end of the day when they’re exhausted, asking them what they wish is just another mental burden to put on them. And most people have a hard time asking those questions.
The questions that I really like are, “Tell me about a time that you were stressed out and someone did something that made you feel better. What was it?” And so ask them questions like that. “Tell me about a time that you felt really appreciated.” I love those questions. “What’s your favorite snack? What’s your favorite candy? What’s your favorite music? What’s your language of appreciation?
And there’s a book, it’s called, The Five Languages of Appreciation in the Workplace. It’s written by the guy, who wrote The 5 Love Languages. They’re the same book. Just so you know, they’re the same book and one of them is just work appropriate, but it’s good stuff. If you want a quick read, there’s five languages that make people feel appreciated. I’m going to try to rattle them off, but it’s words of affirmation, it’s service, it’s quality time, it’s gifts, and it’s physical touch. Bam, nailed it. That’s the five. But anyway, and you can dig into. It’s a good book for anyone in management and motivation to read and you can skim through it and get the gist of it pretty darn fast. But those are the things you say. And what resonates with my people?
I really like the idea of having a sheet that, and you have to update this every now and then. You can’t be like they filled out a sheet when they came to work here and I’m like, “When did they come to work?” And you’re like, “Seven years ago.” I’m like, “How do you know they still Butterfinger?” It’s like, “Who stops liking Butterfinger?” People’s preferences change and so, just update it. But some questions like that, not when things are on fire. Those things are good, but it helps you figure out what motivates people, so that we can do those things.
One of the things you can always do in the moment, always in the moment, is when people are really working hard, go the extra mile to make them feel seen. It doesn’t cost anything. You don’t have to buy anything. It’s just taking a moment to say to somebody, not I appreciate you or thank you because those are just really generic.
It sounds something like, “Hey I want to tell you, I saw earlier today when we took that patient out of its little den and you dove in there and just cleaned it out and wiped it down and you were just on it. And I just want to tell you, I recognize how hard you work around here. And I recognize that you could have been like, ‘That’s not my job,’ and backed away, but you didn’t. And I just, it’s hard for me to express how much I appreciate you and what you do here.” And if that sounds heartfelt, it’s because it is because I’m imagining one of my techs.
And you go, yeah. It’s not buying anything, it’s not having anything, it’s not planning anything, but sometimes people just want to feel seen. And that is something that we can always do, but you got to be present. You got to be on the floor. You got to be paying attention and you have to set out to do it and you can’t do it for the whole team at once. It has to be a thing where you catch people, who are really going to town. But anyway, that is something that even if you’re unprepared, you can make people feel seen, but you have to give it a little bit of thought and you have to get their attention if to talk right to them, look them in the eye, and make them feel seen.
Jen asks, “What’s the best thing to do when you’re feeling overwhelmed?” She has a follow-up question, which is, “What advice would you give to those who are having trouble setting boundaries at work?” I’m going to take the first one first. “What’s the best thing to do when you’re feeling overwhelmed?” I think a lot of us are feeling overwhelmed. I’ll run you through my list.
Number one is make a list. I think of like Dumbledore is pensive. A lot of times, we’ve got this nebulous list in our brain. And I tell you that’s the worst part for me of feeling overwhelmed is the emotional feeling of, “I just have so much to do,” and you’re like, “Andy, what exactly do you have to do?” And I’m like, “I don’t know. Just everything. I just feel like I have to do everything.” I think a lot of us get that place. You got to get out of there and the quickest way to get out of there is you have to crystallize what you’re up against.
You have to turn this nebulous cloud of stress and anxiety into something tangible that you can look at and measure up and make some plans about how you’re going to address it. So, the first thing is just get it down. You can use a to-do list app. You just write it on paper, but you’ve really got to take the floating anxiety in your mind, which is driving that feeling of overwhelmed. You’ve got to translate that into something tangible that you can actually see.
And then you look at this list and you ask yourself what here is actually on fire and what’s just smoking from the things around it? And I think a lot of us struggle with that. We say, “Everything is on fire.” It’s like, “No,. Everything is not on fire.” You got a couple of things that are on fire and you maybe have one significant fire. Everything else is just reefed in smoke from those burning fires, but it is not actually on fire, which means those problems can sit until tomorrow and you should feel okay with them.
I’m a big fan of everyone, people make to-do lists and they’re like, “This is what I have to do today. And if I don’t do this today then I’ve failed.” And I go, “That’s ridiculous.” It can’t be about what you did today. It’s got to be about, “This my to-do list and this is what I’m going to do today. And this is what I’m going to do tomorrow. And this is what I’m going to do next week.” And you’re already lifting that overwhelm off your chest just by saying, “I see this and I’m saying it’s important and I commit to doing it next week.” And you can do that.
And I think we have this horrible tendency as a human being species to wildly over imagine what we can do in a day. And we under imagine what we can do in a year or in five years or in 10 years. And so, the biggest problem is we look… I mean, how many of us have had these to-do lists and we have 10 things on them and we’re like, “Yeah, I’m going to do this today.” No, you’re not. You’re going to do three things on that list or maybe five things on that list and then you’re going to feel defeated because you didn’t do 10 things.
And I would say, “That’s ridiculous. You did five things on your to-do list today.” That’s bonkers. If you do three things on your to-do list and keep a clinic going and keep a family going and feed yourself and wear pants, then you have succeeded in the day and you should be happy about that. That’s what you should do with your to-do list. So, what here is actually on fire? And then what’s just smoky from the things around it? What’s mission critical? What’s causing the most pain? Meaning, what is bothering me the most?
Some of this is mental health stuff, where it’s like, “I understand organizationally what the top priorities are, but this squeaking chair makes me angry every time I sit down in it.” And I would say, “That’s causing you pain.” Yes, there’s other things that are important, but that squeaking chair is bothering you every time you sit on it. And it’s affecting your head space and your enjoyment of being here, and so, for me that is a thing that’s actually bothering me more than anything else. So, fix the chair. Just grease the chair. If it’s causing you pain, then fix it.
And the last thing is what will free up my capacity? And so, I’m looking at my to-do list, what is mission critical? What is bothering me the most? And the last thing is what will free up my capacity? Meaning, I want to prioritize the things that are going to give me more time to deal with the other things.
And so, you might have something on your task list and say, “This is not super important but it takes a ton of time and people keep asking me about it and asking me about it and asking me about it.” And I go, “Well, if you got that off your list then people will stop asking you about it and you would have time to do the other thing.” So, even though it by itself is that important, getting it done will free up your capacity. And so, anyway, those are the ways that I look at being overwhelmed. I hope that that’s something helpful.
The second follow-up question is, “What advice would you give those people have trouble making boundaries at work?” And I kind of touched on this when I talked a little bit earlier about the phone calls and people wanting to get in and us not having space. The big keys for me in setting boundaries at work is you need to make boundary decisions intentionally and when you’re not in the moment. The biggest way that we fail in personal boundaries is we are like, “When it happens, I will say no.”
No, you won’t and that’s okay. It’s because you’re a good person and you want to help people and if you have not clearly committed to what you’re going to do, then it’s a toss up in the air. And if it comes down to looking at this person who’s got tears in their eyes and saying, “No, I’m not going to help you,” and that’s boundary setting, then you’re going to fail every time and you probably should because it means, again, that you’re a good caring person. The only way to make this stuff happen, guys, is to think about the boundary failings that we have.
Where do we fail to set boundaries? How do people set us up, so that we say yes and then we regret it or we’re resentful later on? If you were having those experiences where you say, “I feel I say yes and then I’m angry about it later,” I would say to you, my friend, that’s resentment. You are feeling resentment. And the fact that you did this and you felt resentful of it, to me that means you need to fix the problem for next time. And that is about making decisions when you’re not in the moment. Moral decisions made on the floor are a real problem and they’re one of the big problems in why we don’t have good boundaries in vet medicine.
Because we’ll say things like, “Oh, when the client comes in at the end of the day and if they get in the door before we close it, then it’s up to the doctor whether or not we see them.” And I say, “So, you’re going to see them is what you’re saying?” Because the doctor is almost certainly not going to be able to look at this person who says, “Please don’t make me leave. I drove all the way over here and my dog is sick. And please don’t turn me away into the cold.” They’re going to say yes, because they’re good people.
And make the decision ahead of time. “We close at 6:00. We don’t take walk-ins after 5:30.” And it’s not a question of asking the doctor because the doctor is not empowered to make that decision. Has a policy decision that was made and we will apologize and let them know where the emergency clinic is. That’s it. Maybe one of our techs can look and say, “Yes, this could wait until tomorrow,” or “No, it needs to go to the emergency clinic.” But that’s as much as they get, but that’s a policy decision.
I mean, I know it all comes from a good place. It comes from us saying, “Well, I want the vets to be able to look at this.” And try to take care of our clients. Nobody is bad here, but at some point you got to look and say, “In this world where people are burned out and they’re overwhelmed and they’re working and they’re working and they’re working, if that’s the reality in your practice, you, my friend, you need to set policies that protect your people.”
Now, in 10 years when there is a global pet shortage and you got nothing but free times, you can change that policy and say, “No, when they come in, we’re seeing them. You know why because we only see five appointments a day?” Then that’s a whole different thing.
I’m not saying you have to do that, but you can. Things change. And the fact that you make a policy right now doesn’t mean you’re not going to relax that policy when you hire the three doctors you’ve been trying to hire for the last two years, then you can make that adjustment. But right now, you got to make the decision, make it ahead of time, make it with clear eyes, make it non-emotionally and just make it. In order to do that, because a lot of people go, “But this is painful, Andy. I feel bad turning people away or setting these boundaries or telling people no.” There’s really two mental shifts that have to happen if you want to feel okay with this, in my experience.
The first is you have got to stop thinking in the short term and think in the long term. I alluded to it earlier, but if you look at everything that walks in your door and say, “I’m thinking about this today and the good that I can do in the world today,” then you are going to suck it up and you’re going to see every patient that comes in and you are going to take every phone call that rings through. That’s not healthy because the goal is not to be successful today. The goal is to be successful for 30 years or for the rest of your career and so, you need to look at it long term.
And so, if you say, “I need to do maximum good in the next couple of decades,” then pacing yourself makes sense. And you say, “Well, I’m not going to stay tonight and take extra cases because I need to rest, so that I can continue to keep this up for the next year as it’s hard to hire people. And as we continue to be so darn busy, I’ve got to pace myself.” And so, I’m not thinking about today. I’m thinking about this year or the next five years or the next 10 years or whatever. But if you’re only thinking about today then you, my friend, you are in a sprint mindset of go, go, go, go. Fall into bed, jump up tomorrow, and go, go, go, again. And that’s not sustainable guys. It’s a marathon. It’s not a sprint.
And the other mental shift I think that people need to get comfortable with is switching from fixating on the person in need to thinking about everyone affected. And so, when the pet owner comes in and they say, “Please, don’t turn us away. I know you’re locking the door and the staff is trying to leave, but we need to get seen for this itching,” if you think about the individual affected, which is the pet and the pet owner and you say, “Ah, it’s help them or it’s don’t help them,” that’s a really hard mental place to get out of. And morally, you think, “Oh, I need to help them.” But those are not the only people affected, are they?
Your staff is affected. Your staff wants to go home. They want to go see their families. They want go home and recharge. They have hobbies that they are looking forward to doing. They want to rest. They want to do whatever they want to do. It’s their life, but they want to live their life. So, if you say yes, it’s not just about you and this pet owner, it’s about you and the staff and doctor and payroll if you put people into overtime. And more importantly, it’s about your family at home and the time that you’re not getting to spend with your kids and your spouse or doing your hobbies or relaxing. What does your boyfriend think about you staying late every night? If he has concerns, then he’s being negatively affected by you saying yes.
I’m not saying you say no. I’m not saying you say yes. It changes. But what I’m saying is when you make these decisions, you need to not think just about the person in front of you who’s asking for help. You need to try to balance what is being asked across all stakeholders, which is them, which is the staff, which is the doctors, which is the practice, which is your friends and family who are waiting for you to get home or your pets who need to pee because they haven’t been let out since lunchtime.
All those things matter and it’s a whole lot easier to set boundaries if you look at everyone’s needs and how everyone is affected and go, “Just I can’t do this. This is not in balance. There’s too many ripple effects from this.” And again, this math might change in the future. If you never come home late and somebody shows up and says, “Please squeeze me in,” then maybe you do that and it’s because it’s a rarity, but if it happens every day then it’s okay to say no now. It’s just interesting. There’s no all or none, but it’s about being healthy and being intentional about where you are.
And the last thing that I’ll say about setting professional boundaries, and this is kind of hard to hear, and I just want you to sit with it a little bit. And I hope that neither of these things is true for you, but if you have to make a boundaries decision and the decision comes down to feeling guilty or feeling resentful, choose guilt. Choose it every time.
And what I mean when I say that is if your choices are to set a boundary and say, “No, I can’t do this and I’m going to go home and I’m going to feel guilty about it,” or to say, “I’m going to make this happen. I’m going to stay and do this. I’m going to sacrifice this boundary. I’m going to make this exception and then I’m going to be mad about it. And I’m going to go home and I’m going to be angry at myself and at my staff and at my job.” That anger eats you up. It will.
Go home and feel guilty because that beats the heck out of going home and feeling resentful and angry because that’s a path to a dark place and you don’t want to be there. I hope that you can rationalize in your head. That’s why I talk about thinking in the long term, thinking about everybody infected because I want to help you deal with that guilt. But if it comes down to it, you got to choose guilt or resentment. Choose guilt.
Okay. Jody asked, “How do you bridge the gap between the front and the back?” It’s probably one of the most common management questions I get. There’s a lot of communication issues between the front and the back. And people always ask, “How do you,” when she says, “bridge the gap?” Generally, it’s making these people know and respect each other. It’s making them assume good intent about each other. Meaning, the front assumed that the back is trying their best and the back assumes the front is trying their best. How do we make those things happen? How do we make these people, who are physically separated? Generally, they’re in different parts of the building. They’re having different problems. “How do we get them to bridge the gap,” as Jodi says?
And the first thing is I think is really important is a shared mission. We need to talk about what we’re doing here. What are the core values of our practice, of our clinic? Why do we come into work? It’s not to make money. That’s not why anybody’s here. I mean, maybe some of us, but those people made bad choices, but it’s here. We have a mission that we are pursuing and we are a team. And the front and the back are 100% both pursuing that mission and they are both required mission critical for pursuing our mission.
And so, make sure you’re talking about the mission. Make sure you’re pointing to the North Star that your whole team is rowing towards. And if I believe that they’re working in a different place and they’re doing things differently, but they are committed to our mission and I am committed to our mission, suddenly that commonality that brings us together and it makes it easier for me to assume good intent. And if I have conflict, it’s easier for me to talk it through when I believe that we’re both ultimately working for the same outcome and we both are trying to get the same place. So, the shared mission is important.
Focus on interdependence. I want to continue to emphasize again and again to the team that they need each other. The front needs the back and the back needs the front. I think a lot of times, people just like the… I think it happens more in the back. Maybe it’s just because I’m back there and I’m not up at the front. But in the back, I think there’s this idea that the front is just in the way of getting things done, and that’s nonsense. That’s foolishness.
The truth is they are handling the clients and the communication and the phones and the checking in and checking out and they are completely a 100% in this trench with us. And they are helping us do the things that we need to do, and we need them. We need them and they need us. And I think that that’s language that we should use and remind people of is, “Hey, guys, we need the front desk and we need them to be happy. And we need them to help us take care of these clients because without them, all this communication falls back on us and we cannot keep up. We need them. They have a great impact on how our day goes and we need to support them and we need to try to make their jobs better. And they’re going to work hard to support us and try to make our jobs better.” But it comes down to that focus on interdependence.
And the last thing is knowledge about what the other group is doing. Oftentimes, the people in the back do not know what’s happening at the front desk and they do not know what they’re up against and they don’t know the headaches and they don’t understand what it’s like to sit up there and have a waiting room full of people staring at you and they’ve waited 35 minutes and they’re getting frustrated. But that’s just is an experience.
And so I think talking about those things and pointing out to people and say, “Hey guys, it’s hard up front.” And the same thing at the front, they don’t know what we’re doing in the back. They don’t understand why suddenly there’s a huge log jam and it’s like, “Well, they don’t know that the procedures that they brought in these specific ones take a lot of time. And our regular procedures, they don’t know maybe what goes fast or slow or maybe they just don’t know that one of the doctors got caught on a phone call and couldn’t get off and couldn’t get off and now, we’re behind.” If you don’t have a way to communicate that, then they don’t know it and so, make sure that we’re trying to talk about that.
And a lot of people will say, “Cross-training, cross-training, cross-training.” To me, cross training is knowing what the other group is doing and I think that’s good if you can do it. If you can get some of the technical people back up to help with the front desk and answer phones, that’s great. And if you can get some of your front desk people CSRs trained as assistant, so they can come back and help hold pets and participate in the back just for that experience, that’s great. I think that those things are really good.
The bigger thing is good communication. It’s about these people knowing each other as people. And it’s just about them being able to talk about issues before they become big screaming issues. When there’s mild frustration being able to come together and say, “Hey, let’s talk about what’s happening and why it’s happening and what we’re going to do about it.” And that’s just good ongoing communication in the practice. That stops us from getting to the place where we build walls and where we split into groups. And us versus them is a very powerful, very simple way to divide people.
And in practice, if we start having that type of language where there’s us in the back and them in the front or vice versa that leads to division really fast. It leads to a lack of assumed good intent and that leads to anger. So, anyway, those are my big things on bridging the gap between the front and the back.
And then the last one, Jackie asks, “How do you coach someone that gives very blunt delivery of feedback and rubs people the wrong way?” All right. I like this question. This, I get this a lot. How do you coach someone who gives very blunt feedback? I don’t find this to be particularly hard feedback to give. I really don’t. I like it. And so, the big thing is, let me go ahead and frame this up.
So, the first thing that I want to do there, there’s really two kinds of corrective feedback that you can give. The first is critical and the second is developmental. And so, if you give critical feedback then what happens is that’s me saying, “Hey, you messed this thing up yesterday and I want to talk about how you messed it up. Okay?” And so, that’s critical feedback.
Developmental feedback is me saying, “Hey, I want to talk about where you’re going and what I want to see from you in the next six months. Hey, I want to talk about your developmental pathway and what I see as the next big steps for you to take, to move onward and upwards, to be even more fantastic at your job than you are. I want to talk to you about the things that I’m really looking for you in the next year as far as your own personal leadership development.” And that’s developmental feedback and it feels very different.
It’s not me saying, “Let’s talk about how you screwed these things up.” It’s me saying, “Let’s talk about the future and what we’re going to do in the next year.” And so, this type of blunt feedback, I’m not going to hold it as a trial and be like, “Come back in here. Now, you’re going to sit here. I’m going to bring in the first witness to talk about your bluntness when you said, ‘That’s not what I asked for.'” I’m not going to put him on the spot. We’re not having a trial. We’re not doing any of that.
And so, “Hey, I need to talk to you. I want talk about what I want to see from you in the next year as far as your leadership development and where I see potential for you to really blossom.” And then I talk not about them giving blunt feedback because blunt feedback is very subjective. It’s very subjective. What I consider blunt feedback living in the Southern United States my whole life is very different than what my friend, who lives in New York City considers to be blunt feedback. What he considers to be normal communication. I would like, “Oh, my God. You said that?”
It’s a cultural thing. And yeah, I say that with love, but there are places where very direct communication is just the norm and there’s other places where that’s just not how we talk. And so, this person may fit like a glove in another place. I don’t want to lose this person, but what they’re saying is not wrong. It’s just it’s being received in a way that they do not intend. And I talk a lot about how the person is being perceived. Not what they’re doing and that’s big important point in coaching people.
If I say, “Hey, you are doing this wrong,” that’s very different from saying, “Hey, I understand where you’re coming from and I appreciate you enforcing our policies and giving clear feedback. I do and I do not want that to stop. I want to work on how that feedback is being perceived because some people are hearing it as very blunt or they are taking it in a way that is probably stronger than you intend. And so, I want to work with you in how we can deliver the feedback in a way that’s not going to be perceived as over the top or aggressive. I want you to work on softening your delivery, so that it is as effective as you want it to be.”
And that’s how I put it. And really, I hope you can kind of hear that I’m really trying to take this away from being any sort of criticism of the person because it’s a skill criticism. And just say, “Hey, I want you to work on softening your delivery, so that your feedback is as effective as you want it to be. And we can talk about how to do that.” And if they want specific examples, I hopefully can give them and say, “Here’s some of the things that I heard.”
And it’s just, again, a lot of times, communication doesn’t happen at the mouth, it happens at the ear. And we don’t have a ton of control over what happens at someone else’s ear other than to receive feedback and make adjustments based on how they’re interpreting what we’re saying. That’s just life. It’s not a critique of you as an individual or your skill or your smarts or anything else. “I told you what it is. I gave you the feedback. This is where it is. Let’s just make some adjustments and go on. You’re doing great. I appreciate you.”
And that, I try to keep it low stakes and just give that feedback. If you want to unpack it some more, we teach a DISC in Uncharted. So, DISC is a very simple style of communication profile and so, basically people kind of fall into four categories. D is a dominant direct personality type and that’s often the ones that I get the feedback about, “This person is very blunt.” This person is probably just a D style communicator, which is I think it’s great. I’m very comfortable with these, but they are straight to the point. They don’t want details. They’re just, “Tell me what I need to know and I’m going to tell you what you need to know and let’s go on.”
And you guys probably work with those people. A lot of doctors are that way and they can be seen as uncaring. That’s not true. That’s not remotely true. It’s just that they are no nonsense, “Let’s go. Let’s get going.” And that’s their communication style. And what I love about DISC is it breaks people up.
And you can say, “Oh, I know those people. I know exactly who that is.” And I will say, “Great. Do you know how that person likes to communicate?” And you say, “Yes, they’re very direct.” And I say, “Great. Here’s a little trick. They also like to be communicated that way.” Which mean, and that makes the feedback even a little bit tricky if you don’t do it right, because the person is like, “I’m not blunt. This is how I would want people to talk to me.”
And that’s true. That is how they want them to talk. It’s like, “This is how I communicate. I told you what you need to know. Tell me what I need to know and let’s go our separate ways.” And that’s it. And so, anyways, like Ron Swanson from Parks and Rec, goes like, “Tell me what you want and I’ll tell you what I want.” And that’s it. Anyway, I don’t find it to be super problematic because it’s 100% just, “Hey. This is how it’s being received. We need to adjust so that these specific people are hearing what you’re saying and your feedback is effective. Can you work with me on that? Help me soften it.”
And they’re going to have to struggle because a lot of times they’re like, “I just want to say it and go on.” And I go, “I get that.” The worst case is I kind of have to get them to understand how blunt feedback does not save them time. They’re like, “I just tell them. It saves time.” I was like, “You just tell them, and then they come into my office and now, I’m talking to them and it takes me 30 minutes to talk them down. And now, you and I are having this conversation. And if it keeps happening, we’re going to have another conversation like this. And now, if you want to have a good relationship with this person, you may have to go and apologize and tell them that you didn’t mean to come off direct. And how much time does that waste?”
It’s like, “Just soften your delivery. And ultimately, it takes more time in the moment and saves more time in the long run by far.” And so, I might have to explain that. Usually, I don’t. Usually, I just say, “Hey, I want you to be more effective. This is what I need from you is just soften tone, so that people perceive it differently.”
Guys, that’s it. That’s what I got. Those are my questions that I got from the Uncharted community. Thanks to everybody there who dropped those questions for me. Gang, I hope you enjoyed it. It’s been a fun experiment. I’m going to go back to the lab and tinker around on this and maybe we’ll do some more of these. Maybe we’ll switch it up a little bit. I don’t know. We’re going to see what happens.
But anyway, gang, thank you guys so much for being here. If you enjoy the podcast, lead me an honest review wherever you get your podcast. If you’re watching on YouTube, click that Like and Subscribe button. Gang, I hope you all are well. Take care of yourselves. All right, talk to you soon. Bye.