Dr. Andy Roark engages in a dynamic conversation with Certified Veterinary Practice Manager, and Licensed Veterinary Technician, Bash Hallow. Together they delve into the art of navigating difficult conversations within veterinary practice and the significance of understanding clients’ needs for effective communication.
This episode is made possible by Purina Institute!
ABOUT OUR GUEST
Bash Halow CVPM, LVT, is a graduate of the College of William and Mary, a certified veterinary practice manager and a licensed veterinary technician. As a veterinary business advisor and a veteran practice manager with more than 23 years of experience, Mr. Halow has helped dozens of veterinary hospitals understand how to build stronger teams and responsibly and ethically grow their businesses. He is a frequent contributor to DVM 360, Vetted and other publications like AAHA Trends and Today’s Veterinary Business. He is a member of the advisory board for the Fetch360 veterinary conferences. He has been an invited speaker at all the major U.S. veterinary conferences including AVMA, AAHA, VMX, Western, Midwest, CVC, IVECCS; state associations, and international conferences like APVC, OVMA, the Alberta Veterinary Medical Association and addressed the Veterinary Management Association at the House of Lords, London, in June 2018. He is a member of the American Animal Hospital Association, the PVMA, founder and member of the New Jersey Veterinary Hospital Management Association, founder of the Big Apple Veterinary Management Association in New York City, and proud member of the Veterinary Hospital Managers Association. Mr. Halow was the 2013 recipient of the Pennsylvania Veterinary Medical Association’s President’s Award for management education in the state of Pennsylvania. He resides in New York City.
Dr. Andy Roark:
Welcome everybody to the Cone of Shame Veterinary podcast. I am your host, Dr. Andy Roark. I am here with my friend, the one and only Bash Halow. Bash is a men of men and talents. He is a fantastic speaker and presenter as I talk about when we get started. He’s a CVPM. He is a credentialed technician. He is a professional consultant, but we get into a conversation that I enjoy, which is hard conversations with the staff. It’s just every team has difficult conversations to work through. There is healthy conflict and there’s unhealthy conflict. I see a lot of teams that struggle with this. I don’t think we have near enough conflict management training in our profession and that shows, and so I get into talking with Bash about this and we talk about training and just getting your staff and your team up so where they can communicate effectively with each other.
So this is a really good episode that’s just packed with pearls and so anyway, I’m super thrilled to have Bash here. I could not do it without the Purina Institute. They are bringing this episode to you ad-free. A couple of things from them. One, if you have not taken a look at the Clinical Nutrition Handbook that is made available by the Purina Institute, it is a hundred percent free. I’ll put a link in the show notes. It is wonderful. You should get it, have it on your phone, have it on the clinic computers. It is just such a wonderful resource. Also, if you haven’t done it, be sure to check out the Purina Institute Center Square resource on purinainstitute.com. A fantastic wealth of information, lots of staff training resources, just a really incredible way to learn and grow yourself and your team. And so anyway, both of those resources available are made available by the Purina Institute. I’ll link to both of them. Let’s get into this episode.
Kelsey Beth Carpenter:
(singing) This is your show. We’re glad you’re here. We want to help you in your veterinary career. Welcome to The Cone of Shame with Dr. Andy Roark.
Dr. Andy Roark:
Welcome to the podcast Bash Halow. How are you my friend?
I am so good and it is a pleasure to be here with you.
Dr. Andy Roark:
It’s great to have you here. You are such a fun guy to talk to. So I have known you for years and years. You are going to go off script here for a second. How I know bash you are such a dynamic presenter and public speaker. I love your energy. You’re one of those guys who comes in and so I’ve done a lot of public speaking and a lot of times people who go in and do presentations are really kind of affected by the energy that’s in the room, which means if you have people who are really enthusiastic, they’re enthusiastic and they have people who are not that enthusiastic or they’re tired first thing in the morning, then the speaker’s energy is kind of down and you’re one of those few people, Bash who can take an audience and put them on your shoulders and just carry them from an energy perspective.
Like you can lift a whole room up and that is such a rare thing to do. I can tell you from experience, it’s exhausting to try and you do it as effortless as anyone that I’ve seen. You are a certified vet practice manager. You are a licensed veterinary technician. You are the principal at Halow Consulting. You are a gadfly man about town, a veterinary socialite. I don’t know. You are into all the things. Yeah, that’s how I know you. I got the chance have you on the podcast to talk about one of your fores, which is difficult conversations. So I’ve heard you lecture on this a number of times. You talk about it from the perspective of a practice manager and then also from a licensed veterinary technician. You practice as a technician for many years. I just think you have a really great perspective on this from different roles.
And so when the idea came up to do some hard conversation sort of strategies, I was like, I think this is our guy. So anyway, thanks for being here and talking to me about it.
Well, I need to thank you for that wonderful introduction and that enthusiasm probably has a lot to do with probably the people on the call can relate is that especially if you’re a leader at a hospital and you’re making decisions or you have ideas and it feels like you’re all alone. And boy, I would go to conferences as an attendee and I would hear things. I would go back to the practices and I would try them out and they wouldn’t work for me and I’ve just felt like a failure and I felt alone. And then when I had more of an opportunity to engage with audiences on those topics, I became excited because I was trying to figure them out along with the audience and also make friends in the industry create relationships that I could turn to so that when I went back to those practices, I could have somebody to call if I was running into difficulty.
But it’s interesting that you talk about that enthusiasm. Sometimes I’m up there enthusiastically talking about some idea that I’ve cooked up and you look out and there’s crickets in the audience and you realize I’m the only person that gets excited about this idea. Maybe like today’s topic about valuable covers, we call it difficult conversations. I really don’t validate your mouth, but I actually think that when you do them right, they really can be valuable conversations.
Dr. Andy Roark:
I coach a lot of young presenters and speakers and things and educators and one of the big things I always try to say to them is if you walk in there to try to teach others and you think your learning is over and you think you have the answer and you can’t get better, you’re really limiting yourself. The best presenters and educators are people who go in and teach and they walk away having learned more or at least they’ve added to their treasure trove of knowledge.
They have picked things up as they go. And so I have always found that working with an audience is one of the best ways to improve as an educator because they raise awareness of holes that you have in your arguments and in your ideas. They ask really hard questions because you can’t hand weigh through that stuff. I think one of the hardest things about difficult conversations, especially when we’re training, we’re working with staff members, we’re talking about how to get better is I’ve never bought this idea, Bash that there is a right way to have hard conversations. I’ve seen people roll up and they sort of have this expert hat on like, I’m going to tell you how to do this, and I go, I just don’t buy that. I think there’s too many variables. Everyone has sort of a different style and there’s definitely core concepts we have to get, but I think you’re going to have to hold onto those core concepts loosely.
Do you agree with that?
I absolutely agree with you. And when you were talking about teaching, a lot of times we have this idea that, and in Vet Med we’re going to go in there and we’re going to provide client education and that’s going to equal better service and that’s also going to equal higher sales. And I bought into that as a practice manager and as a technician I bought into that clearly I love to talk. I love to be a source of information that I think is going to be valuable. And so while I was in it and doing it all the time, it seemed right now when I’m on the outside in my capacity as a business advisor and I’m watching veterinary teams educate clients, I see that they’re doing that thing that you say is a turnoff to audiences, which is they’re not first coming to the table ready to meet the client where they are.
They are in their needs, their goals, their understanding of a thing or even their own emotions. And so when you’re talking about whether it’s having a difficult conversation with an employee or a time with a client, you cannot go in there with an agenda because it presumes that you know everything about the situation and you have to go in there first ready to listen and to learn and meet that individual where they are. Then I think that you can make a real connection and a difference in their lives.
Dr. Andy Roark:
I love that you say that it requires, oh, so let me just ask you this as a question actually. Does it require a greater level of mastery of the subject matter to go in and meet the client where they are as opposed to knowing what your script is going to be and go in and saying, these are the points that I want to make?
Well, I’ve had a lot of experience with scripts and I’ve turned off a lot of people with scripts in my day, again, interested in selling things. I thought that was what was going to mark was going to stamp my success was make sure that I had high sales, is that I’ve tried to teach people how to talk about things and trying to shove that script down people’s throats is only resulted in a lot of choking and gasping. It was only when it’s true, only when I really was able to help people understand the value. If they personally understood the value of what it is that they were doing or the value of the products that they were selling, then they were very good at marketing those services and products to clients. So I would say that certainly, certainly you’ve got to go in there with a desire to learn about what the client needs and wants and also what you believe they need, what you believe that pet needs.
But I also think it’s important that you understand the value of what it is you have and it’s worth in this specific case. So I don’t think that you can just go in there without any knowledge. It’s important that we’re all regularly given access to training on the value of the services that we have. We were talking earlier about nutrition that’s just coming to mind. The Purina company that’s sponsoring today, they’ve got an excellent website that’s a source for education for team members, team members called Center Square, and that’s just a great way to give your team members little bites of information that they can take day by day as they move on in their journey and training and learning. But it’s a combination of being able to go into the room, be ready to listen and watch for opportunities of what this client needs and what you think they need and then matching it with services and products in your practice that are of value.
Dr. Andy Roark:
How do you train people to do that, Bash? So if you’re not doing scripts, which you and I both agree going in with a script, just people can smell it. As soon as you start to say something that’s sort of in my experience, as soon as you start to say something, they recognize that this is a script that you’re going through. Everybody’s seen other people do it, right? We’ve all been at the dentist’s office and the hygienist starts to tell us about their recommended payment plans or whatever. You immediately go, oh, this is a script. What does training look like? Let’s just use nutrition. So we’re talking about that. If I want to not give my team scripts, but I want them to be prepared to go in and have hard conversations to meet clients where they are, to try to recognize what the needs of the clients are and then sort of communicate value.
How do I train, how do I know that I’m sending people in one in a way that they’re going to have a consistent message across my team because that’s important. I don’t want people to be like, Hey, go in there, see what they think, make some stuff up. You know, freestyle. I’ve seen practices do that. That’s not good. So one, how do I get ’em to have a consistent message? And then number two, how do I know that they’re not in there just blowing smoke or that they’re telling half truths or things like that. I want to do some quality control as well, so how do I train for that, Bash?
Well, it is so true. You’re actually the first person in a long time that’s told me that you worry about what team members are saying in the rooms because we should work with that. Yes, I’m in there.
I listen all the time and it’s not ideal for all kinds of reasons that we can get into in just a moment. And through no fault of their own, you send a team member think about it, we’re sending, we have up at the front desk, we’ve got people usually who are in their early twenties and they’re female and all the time they have to look at clients and say to clients, well, Mr. Halow, how was today’s visit? That’ll be $1,780 today. And that person up there has never paid a bill in their life higher than probably $150 and they have to stare down this client who just hearing the news that their bill is $1,700 and they’ve got to, we’re expecting them to somehow walk them through understanding the value of that or whatever when they just don’t have the life experience to do that.
The same happens in the rooms when we’re asking our assistants and our technicians to go over estimates for urgent care or emergency situations where the energy in the room is really fraught and they’re supposed to go over a bill that could, I dunno, be as high as four or $5,000 when they just don’t have the life experience of how to do that. Any other real training except, well, it’s common sense. It’s common sense. Just give great service. So I do think that you’re very wise to think about what it is that’s happening in the room, and I wish more people felt like they could do what I do, which is just be a fly on the wall at the front or a fly on the wall in the rooms and listen for clues as to where we need more training, not as a way to accuse or blame.
Certainly not that just as a way to figure out where we need more opportunity to train. But if I’m not being too long-winded, can I just say that to train those conversations, it begins with hopefully you have team members that you’re hiring that are interested in the things that we promote that have an interest in science behind what it is we do and also really are sitting in the front of their chair when it comes to wanting to help clients and wanting to help pets. Certainly, I hope that’s what they bring to the table and then giving them the education in the background to understand how things like nutrition or whatever other service that we’re promoting at the practice can be matched to the kind of caseload that we see. And in the case of nutrition, it can be, I mean, you can make a very strong, compelling, legitimate argument for nutrition to be a consideration when treating cognition issues, weight issues, life stage issues, heart issues, lower urinary tract disease issues, allergies, allergens, and on and on.
So almost every single case that comes through our door, there is probably a pretty good case to be made that we should think about how nutrition plays into this case and then use the cases jumping off point to talk about what it is we have to offer. That’s a great way to meet the client and the patient where they are right now.
Dr. Andy Roark:
Yeah, I really like this sort of case study approach. We also know that role-play training is about the best type of skill building that we can do. And so being able to present these cases and say, how would you approach this and what would you say? I think that makes a lot of sense. Bash, if someone’s buying into this fly on the wall idea, and I really like it. I really also very much that you said, I wish that people could be a fly on the wall not to punish, right?
This is not about catching people or criticizing people. It’s about developing them and growing them and sort of sharpening the saw. So I like that approach a lot. What does that look like in your mind? Are there ways for lead technicians, for practice managers, for medical directors to know what’s going on in the rooms and are there ways that you’ve seen that tend to work particularly well?
It’s interesting that you said that role play is a good way of training people, and I’ve found that that is one way that appeals to usually some extroverted people. I’m not sure it’s the only way. I think that there’s a process’s called design thinking. I talked about it last year at VMX and the resources are available on my website, but the process allows ideation from your group members and it encourages instead of sitting around and talking about how we train or how we learn or how we serve, it invites teams to work in small groups and actually get up and move through the practice and move through the cycle of service.
And I would say that is another great way to draw your team members into a dialogue about how it is we do, what we do and why we do what we do and to get those members of your team that might feel a little exposed in a role-playing model, an opportunity to talk because it’s a smaller safer group to do that. And I don’t know, and I’m not avoiding your question here, but I want to say that the other thing that is so valuable that I learn when I’m in the room, it’s not just about how individuals talk, it’s about the process in general about how we deliver care. And for years, as I said, I promoted that traditional cycle of service that we have where people have a need with their pet. They call up the vet, they’re confirmed, they walk in, they check in, they warm the bench, a technician comes to get them, et cetera.
I’ve promoted that for years because I felt like at each and every one of those junctures, there was an opportunity for that team member to talk to that client about a particular service or product that I wanted to promote. I could train that individual specifically on that part of their job, and we saw success and we saw sales. What I see now, even after years, I mean with great shame that I tell you that I push that also down people’s throats or up the other end, whichever way you think work better to get that message across. I see now that process is not ideal to meeting that client and that pet where they are, which is what I said was so important because usually at each and every one of those junctures, that new team member has to get uploaded on what this thing is before me.
So when you check in at the desk, they got to figure out Halow, look in the computer and figure out who the ow is. Then the technician’s got to look through the chart, maybe she looked through the chart, figure out who Halow is, goes in the room, looks in the computer, figures out more about Halow. Then the doctor comes in, they don’t know anything about Halow. They got to look in the computer and I’ve found that each and every one of those junctures is often a time for us to be hanging out near the computer, interacting with the computer, and it’s not ideal for relationships. So I’m not sure if this is really answering your question when you talk to me about observations of the team and what to do with it, but that fly on the wall, does it just identify how individual team members may need help?
It’s also understanding that this whole cycle of service that we’ve embraced is probably not ideal for relationship building. And I’ll just add this because I’m sure that there’s a million eyeballs in your audience rolling back in their head like, oh, Halow, you don’t understand. It really works, blah, blah, blah, blah, blah. If you don’t believe me, just think about your own doctor experience, which is the exact same cycle of service. And if you would just picture, and I actually asked audiences all the time when they’re thinking about their cycle of service to imagine their own experience with their doc, getting that text message confirming the appointment, walking into their doctor’s office, checking in with the front desk, warming the bench, the interaction that they have with their nurse, the interaction that they’re having with the doctor. I asked them to think about that because it is an exaggerated version of the same thing we’re doing.
We’re not nearly as bad as on the human side, but we got a whiff of that going on in our practice and I think we can fix it.
Dr. Andy Roark:
So I like this. Let’s talk about fixing it. So if a cycle of services is not good for relationship building, and I think that that’s totally true and that interface is very much with sort of a spectrum of care approach about client first, patient first approach, sort of being flexible to the needs of the people that we’re trying to service, things like that. If that’s not the approach that we want to take for relationship building, what’s the alternative? Where do we go from here if we’re not doing that classic cycle of service and not focusing on it? How do we prepare our people? How do we get the education across? Because it’s two sides, right? I totally, we’ve talked a lot about scripts not working.
We’ve talked about a lot about education and educating the client being a really hard sell and kind of making it feel like we’re forcing down their throat. If that’s not the path to getting compliant clients, then what is?
You know, I’ve spoken to some vets recently who are really into nutrition and those people, I’m sure in their practices lead entire teams that are really in nutrition, they’re like walking billboards for their understanding of the value of nutrition or else whatever the service may be, whatever product or service you’re offering. When you have people like that, they don’t spend a lot of time educating clients about the value of nutrition. What they do is they bring the client in the room, they listen to the presenting complaint, they ask them open-ended questions to make sure that they’re getting more information about where the client is on this particular topic or what their thinking is or more of their habits around whatever’s happening.
And then they tell them what they think they should do. There’s not a lot of it. They don’t have to prove a lot. They can just say, in my experience, this is what I would recommend. They’re so sure of the service and the product that they’re recommending, and if it’s nutrition, they’re pretty passionate about it. They just tell them what they think and if the client requires additional education, they can provide it. But I would say the most compelling relationships in the room, the relationships that I think that are strongest between the client and the veterinarian and the kind of interactions that lead to the highest sales are not equal to more education. It’s equal to more understanding what you think the client wants to achieve and then telling them what you think will work and believing and believing it. That confidence is a big key.
Dr. Andy Roark:
Bash, this has been great. I’m going to put a link in the show notes to Purina Center Square, which you mentioned earlier for exam room communication training tools and things like that. I’m going to put a link to your website for people who want to learn more about design thinking. Are there other resources that you really like when it comes to conversations or training like this?
No, I think that Center Square really is great. When you sign up, you get this free nutrition handbook. It’s a clinical book on nutrition, which is just excellent. So it’s a free copy of it, and then the training is doled out in bite-sized chunks so that your team members, even if they only have five minutes, can look on the site and glean something new. The way that it’s organized, everything about it is great. And when we were talking about Open-ended questions, they’ve got a number of videos there by Dr. Sarah Abood or Dr. Julie Churchill who they demonstrate how to do that. And I think it’s a lesson that everybody on this call should have to learn how to ask more open-ended questions. One of the big mistakes that we make when we’re trying to jump into education or we’re trying to get our way in a conversation is we’re asking these close-ended questions like a yes or no. So are you feeding your dog a lot of fatty treats? Yes, well, and it’s a source of blame. As soon as they answer that yes or no, it sounds like a gotcha question and you establish that there’s blame there. Whereas with an open-ended question, you’re more exploring. It’s more of an opportunity to learn what the client thinks and what their goals are, and it’s a better way to introduce your ideas for change. And I think, as I said, that website does a great job at distinguishing between how to ask questions better so that we get better information and then tee up a conversation about what we believe is best for the pet and client.
Dr. Andy Roark:
I think you’re spot on Bash. Where can people find you online? Where can they learn more from you?
Bash Halow.com is a great place to start. That’s all my contact information and I’ll be doing VMX this year. If you’re going to be in Florida, I’ll be done VMX, and I’ll also be at Long Beach for the DVM 360 fetch conferences, so awesome. And plus other places in the country. If you’re around, I’ll be there. But those are the two big conferences this year.
Dr. Andy Roark:
Well, Bash, thanks so much for being here guys. Thanks for tuning in, listening, take care of yourselves, everybody. And that’s it. That’s our episode. That’s what I got for you. Thanks so much to Bash for being here. Thanks to the Purina Institute for making this possible. Again, check out Purina Center Square. If you haven’t, check out the Clinical Nutrition Handbook, which I link in the show notes, which is totally free, and it is an amazing resource, gang. Take care yourselves. Be well. I’ll talk to you later. Bye.