Life With Clients

Steve Dale, certified animal behavior consultant (CABC), joins Dr. Andy Roark to discuss what modern pet owners want. Steve explains the rise of the “fur baby” and how that cultural shift has intersected with a larger demand for convenience and immediate service. Steve imagines what the desired pet owner experience looks like today, and what it might look like five years from now.

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

LINKS

Steve’s Blog & Website: https://stevedalepetworld.com/

TikTok: @groucho_thefunnycat

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

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

Dr. Andy Roark Swag: drandyroark.com/shop

All Links: linktr.ee/DrAndyRoark

ABOUT OUR GUEST

Steve Dale, certified animal behavior consultant (CABC), has reached more pet owners over the past few decades than any other pet journalist in America.

He is the host of two nationally syndicated radio shows, Steve Dale’s Pet World and The Pet Minute (together heard on more than 100 radio stations, syndicated Black Dog Radio Productions, since 2005). He’s also a special contributor at WGN Radio, Chicago, and program host of Steve Dale’s Pet World (since 1997), and host of Steve Dale’s Other World, a general talk show (2020). He formerly hosted the nationally broadcast Animal Planet Radio.

He’s currently a writer and contributing editor for CATster, columnist for DVM 360 where he also serves as a member of the Editorial Advisory Board. He’s also a columnist for the Journal of National Association of Veterinary Technicians in America. Steve is Chief Correspondent at Fear Free Happy Homes.

EPISODE TRANSCRIPT

Dr. Andy Roark:
Welcome everybody to The Cone of Shame veterinary podcast. I am your host, Dr Andy Roark. I’m here with the one and only Steve Dale today. Steve Dale is… How to you describe Steve Dale? He does a million things. He’s a host of four different radio shows, he is a pet journalist, he’s a writer. He’s got more books than anybody that I know, I think. He’s just a fascinating, interesting person. And I had Steven today and I said, “Steve, help me understand what pet owners actually want.” And boy, he lays down a great thesis. He talks about the rise of the fur baby and what that meant as a cultural shift, he’s talking about how that intersects with people’s demand to have immediate service, convenience culture, and he talks about technology and how pet owners are using technology.
And it’s just… I don’t know. I really like a lot of his ideas. I think he takes a lot of things we all see and he bundles them together into a nice little package that makes sense and then go, “Oh, this is useful in conceptualizing the world we live in right now.” So anyway, guys, I really enjoy this episode, I hope you will as well. Let’s get into it.

Kelsey Beth Carpenter:
(Singing) This is your show. We’re glad you’re here. We want to help you in your veterinary career. Welcome to Cone of Shame with Dr. Andy Roark.

Dr. Andy Roark:
Welcome to the podcast, Steve Dale. How are you my friend?

Steve Dale:
Man, I’m great because I’m here with Dr. Andy Roark. How can I not be?

Dr. Andy Roark:
It is so good to have you. You and I have been friends a long, long time. I was lamenting with you before we came on, I’ve not gotten to see you as much as I used to since the pandemic. For those who don’t know you, it’s hard to give you a title. You are a certified animal behavior consultant, you are a frequent writer. I think I saw one of your columns in today’s Dot Business, Recently, you have a blog at stevedale.tv. You have chapters and contributions to countless animal and veterinary books. You have four radio shows. You are like me, you are a man of many interests and hobbies. So thanks so much for being here. I was thinking about you recently and I was looking at some-

Steve Dale:
Oh, oh.

Dr. Andy Roark:
I know. I was looking at some of your writing and, Steve, I think the title that I would give to you. I don’t know that there’s anyone else who is enmeshed in veterinary medicine that thinks about the experience and the perspective of the pet owner as much as you do. You are a real advocate for pets and especially for pet owners. And I think a lot of times when we start talking about the future and I like to sit and think about where all this goes, I can’t help but look at it from the perspective of a veterinarian or someone who’s very much an insider in veterinary medicine.
And so I was sitting there and I was thinking about the future and I was thinking about artificial intelligence and how it interfaces with pet health and with pet owners and with, who knows, products, technologies that pet owners are going to want to use, I was thinking about home delivery of products and services, I was thinking about mid-level practitioners and all of these things, and I was like, “I wonder what pet owners want in all of this, and I wonder where their mind is.” And I don’t know that there’s a better person than you to start to have those thoughts because you do so much in that space of listening to pet owners, talking with pet owners, things like that. And so let me just pause here for a second. I’d like to open this up and say Steve Dale, when you think about pet owners, the modern pet owner, what do they want and how is it different than five years ago?

Steve Dale:
That’s a big question. So pets have been for a very long time members of the family, but the bond is more intense than it ever has been. I remember some number of years ago when people really began to use the term fur babies. And a lot of your colleagues, veterinarians, and I might have been in that camp too, said, “Whoa, come on. They’re not babies.” But to a whole lot of pet parents, that’s exactly what they are. They are their babies. They feel that they are their babies. And incidentally, and I’m going to talk a little bit all over the place here, but it comes to mind that fear-free and cat friendly practices came along at just the right time. And the reason for that is because today it’s the perception, which is the important word here, is that you are in some way not treating their pet emotionally appropriately.
I’m not talking about medically you saying one thing, I’m talking about the emotional wellbeing of that animal or manhandling the cat, or dogs, but cats in particular. So it wasn’t all that long ago. And I can still go to YouTube and find videos of veterinarians today that the cat is in the carrier, they’re turning the carrier upside down and going, “Come on, cat, get out of the carrier.” And then they get the fishing pullout, the fishing net literally to grab a cat. Well, today’s clients greatly would just walk away. They’re not seeing you ever again. And they may not go to a veterinarian for a very long time as a result of that. They want their pet to feel good during the visit and they themselves want to feel good about the visit. So that’s one thing I think that has dramatically changed.
And that was changing, but then along came the pandemic and the profession infusing X number, and I’ve got the numbers if you want them, but X number of veterinarians and technicians, certified licensed credential technicians into the profession, and at the same time losing more than were entering the profession for a variety of different reasons that we could talk about if you like. At the same time all that is happening, more people bringing a pet into their life. During the pandemic or at the onset of the pandemic, shelters and rescues everywhere around the country, and to a great extent around the world, said, and I quote, “Help,” because they didn’t know what was coming. They didn’t know if their volunteers or staff could go into feed the animals, they didn’t know if anyone could be there just to scoop boxes, take dogs for walks, et cetera. So they needed to clear the shelters like never before in history. And people stepped up.
So the number of pet parents skyrocketed, note it there I said pet parents, not pet owners, but it skyrocketed just almost overnight. So you’ve got that happening. More pets today than ever before, most households in America have at least one pet. There are more pets in America than there are children. That’s what it’s become in this country, and I love it. The problem is all those animals need veterinary care and we are not accustomed to waiting for that veterinary care, and in part because people have left the profession, in part because there are more pets, and in part because our patience as a culture has disappeared. It has nothing to do with veterinary medicine.
You walk into a restaurant, then the waiter doesn’t come in two minutes to say, “What’s your order?” Then you’re up, I’m writing a bad review. We’ve totally, as a culture, have changed. That impacts all service industries, and when it comes down to it, in some ways, veterinary medicine is a service industry. Then add one more thing in, and that is pre-pandemic veterinary medicine was not keeping up with technology. What physicians, for example, or dentists could do and do on a daily basis routinely veterinary medicine was not doing. And now more than ever before, clients are saying, “You need to do this.” And I’ll talk about what I mean by this if in fact you’d like me to.

Dr. Andy Roark:
Yeah. There’s a couple of things here, but let’s go ahead and start with that. But then I want to come to some other things you said. So you’re talking about embracing technology. What is the type of technology that you’re talking about that pet owners are saying, “Why aren’t you guys on board with this?” What are the pieces of that they see? Because when you say technology, I immediately think practice management software. I don’t think that’s what pet owners are thinking about at all, they don’t see that. They’re very much looking at consumer facing software that we are not using. What are you saying, Steve? Are you basically saying that we should have apps? Is that where your head is? What does that mean to you when you start talking about technology that pet owners want?

Steve Dale:
Most pet owners today, back up one step, are millennials, and those who aren’t are… I’m getting my Xs and Zs mixed up here, are Gen Zers, right? Is that right? I think. And what I do know is that millennials have impacted every generation more than any other generation before them. So what they do, their parents are doing, and what they do, those millennials that are old enough or do have kids, because for so many millennials, we’re talking so many millennials, their children, their only children, and I’m in that bucket, I don’t know that I’m a millennial, but don’t argue with me, are their four-legged family members, that’s their kids. But for those that have kids with two legs, they impact of course what they do as well. So on both ends, they are hugely impactful.
And let’s talk about texting, for example, that is the preferred communication for anything, having nothing to do with veterinary medicine for the moment. That is how millennials prefer to communicate. We know that through all sorts of surveys. Well, they’ve taught their kids to do that, and now their kids are old enough in many cases to have pets, and their parents, who we thought they don’t do that kind of thing. But during the pandemic, there are a surprising number of 90 year olds that actually do text. So not only the parents, in some cases their grandparents. And to think that that’s not preferred communication or whatever veterinarian medicine thinks, I think sometimes it’s just not thought about, but in fact it would save veterinarians time and money to utilize Weave or those sorts of services more often just to, okay, you’ve got a dog that came in for a routine prophylaxis.
Instead of calling, you tell me what happens when you call the pet parent, you get their voicemail because they didn’t recognize your number, you get their voicemail because they don’t pick up the phone anyway, you get their voicemail because they’re on the other phone, you get their voicemail because they’re busy doing something else. Then they call you and maybe the line’s busy, and then they forget to call you back. So much time is invested in that. Well, a text is going to go through in all likelihood. What’s more, there are lots of software services that you could send a… What is it? GIF or GIF?

Dr. Andy Roark:
I go with GIF but I’ve been argued with many times.

Steve Dale:
You can send an image that moves. How’s that?

Dr. Andy Roark:
Yeah, I like it.

Steve Dale:
Of the pet, and pet parents love that. So now they can see their dog, quote unquote, smiling and the tech simply reads your pet is ready. Of course, if there’s an issue in that routine dental that turned out not to be so routine, oh, we needed to pull four teeth, after all it’s a 12-year-old Yorkie, then of course you make that [inaudible 00:12:51]

Dr. Andy Roark:
That’s not a gift communication. The problem is we don’t communicate that with GIFs, but no, I like it.

Steve Dale:
Of course, but most of the time they’re [inaudible 00:13:02]

Dr. Andy Roark:
If you dream of doing team training with your team, getting your people together, getting them on the same page, talking about how you guys work together in your practice, I’d love to help you. You can check out drandyroark.com and check out our store. I have two different team training courses. These are courses for teams to do together to get on the same page and to talk about how you do things. I have my angry clients course and I have my exam room toolkit course, and they are both available and there to come out. All right, guys, let’s get back into this episode.
Well, I love it, this goes right back to your point at the very beginning, which was the transition towards fur baby as this powerful term. You are talking about integrating that culture into the communication that we have in a significant way.

Steve Dale:
And it’s not being done now. If you think about it, Andy Roark, you don’t feel well, you’re going to call your doctor maybe, you’ll probably go to a portal and ask the doctor a question, and the doctor will answer very quickly, depending on your doctor through that portal, that is the way human medicine works, that is increasingly the way dentistry is working, you can even make appointments online. Veterinary medicine is not there yet and is what clients want. And the big thing clients want is to do what we’re doing right now, virtual conversations, and it can be done. It comes in two buckets. One should not be controversial. There’s a patient client relationship maybe for 20 years, I don’t know, and still it’s not being done. Registered, certified, licensed technicians can mostly answer those questions. Questions like how is the dog or cat doing following surgery?
That can be a virtual follow-up conversation, which incidentally also shows how much you care, clients want to know that you care, so it’s a win-win. And maybe there’s something that leads to, oh my, let’s increase that analgesic or whatever, because you’re doing that follow-up for behavior. You can actually see where all those litter boxes are in their house or lack of litter boxes, and have that conversation all done virtually. You cannot really, I don’t think, unless you have stairs in your exam room, see the dog or cat go up and down the stairs, and you can’t see them move like they move at home anyway, of course. So for osteoarthritis, of course, I’m not saying that this is a substitute for palpation or for radiographs or any of that, but for follow up, for sure, is Solensia really working, and this other, I don’t know, massage therapy, are you doing it correctly? Are you using the Assisi LOOP correctly? Whatever.
You’re able to go through all of that. These are all potentials, and I’m just touching on the surface, of what can be done and should be done, in my opinion, virtually. But I go further, I say there are services out there now, like it or not, good or bad, services out there now, veterinary professionals, technicians that are licensed, certified, registered technicians, as well as veterinarians that are talking like you and I are talking. I ask you, “My dog is limping. Should I worry? Here, you can see the dog doing what the dog does.” I’m talking to you because I can’t reach my veterinarian, and that’s a big problem for a variety of different reasons, including the fact that we are, as I mentioned, more impatient as a culture than ever before. We don’t want to wait two weeks.
Historically, veterinarians have been so responsive as a profession, people are not accustomed to waiting two weeks because they are their babies. They can’t wait two weeks, it’s their baby. They want to know what’s happening. They need to know what’s going on. And if you’re not able to see me, I need to see somebody else, and that someone else could be Dr. Google, that someone else could be the lady who lives down the hallway in an apartment building who has seven cats, therefore she must know about that.

Dr. Andy Roark:
She must know, yeah.

Steve Dale:
That person could be anyone, a dude at the dog park. Do I really need a Lyme vaccine? I don’t know. I can’t reach my veterinarian. You then can work with these companies that are there anyway. They are there anyway, they are doing what they are doing on the fringe so to speak, but this is what I know pet parents want. And veterinary medicine has said, “Nope, we can’t do it.” I don’t get that, because… Of physicians can, which include pediatrician, which knocks the argument down, the argument has been, well, you’re speaking for the pet. The pet can’t speak for himself. Well, I don’t think an infant can speak for him or herself, and the parent is speaking for that baby. This is no different than the furry babies that the parent is speaking for.

Dr. Andy Roark:
Okay. Wow. That’s a lot. I love where your head’s at, just thinking about where we go from here, you had talked about wait time for care as one of the big drivers. Before we got into technology, you were talking about wait time and you were talking about… I feel like you’re building a pretty robust argument here of, again, going back to the idea that pets have been elevated in the minds of pet owners and now we are at a place where we’ve had a labor shortage, we’ve had more people leaving the profession than coming into it, wait times are increasing, and then we add in technology and you’re saying, okay, well, in your opinion, the fringe outlets where people go to get pet healthcare that maybe veterinarians would not endorse or recommend, you feel like that’s coming up because it’s harder and harder to get into the veterinarian. Just closing the loop, is that an accurate summary of your position?

Steve Dale:
Well, people, for several years have been going to Dr. Google, right?

Dr. Andy Roark:
Right.

Steve Dale:
That’s not new. But given no other choice, people are going to go anywhere they can to get advice. Think about in your own life, you can’t get legal advice from your lawyer because your lawyer is spending all your money on a trip to Bermuda. So instead you reach out to someone else who you know is a lawyer, you ask that question, even though the question you have is about copyright and your lawyer’s a copyright lawyer, and the lawyer you’re asking is a ambulance chasing lawyer, there are none of those, of course, it’s a different kind of lawyer, you know you’re not getting the best advice, but you’re getting sunk. That is what pet parents want.

Dr. Andy Roark:
That makes sense to me. I do buy that. The best example I can give I think is in your own personal health, or at least for me, at some point there’s this gray zone between when I feel bad, when my stomach starts to hurt, and it doesn’t go away for a day. And when I pull the trigger and go see my doctor or I am on Google, and I’m not the only one. I am definitely not the one now who’s like, “My knee hurts. What stretches can I do for my knee? What YouTube physical therapy exercises can I find?” Like I said, I don’t want to live in a glass house and cast stones. And so I do agree that that’s where a lot of people go. When you start to think about access to care, Steve, and getting people in, and meeting this need and saying… Because I’m 100% on board with you, I think people’s patience is getting shorter and shorter and shorter, and convenience really is king.
And people, when they decide they want something, they want it yesterday, and they’ve got Amazon flying things in with drones to drop them on their doorstep, and that’s the world that we’re living in.

Steve Dale:
Access to care, if I may jump in there means…

Dr. Andy Roark:
Yeah, sure.

Steve Dale:
… A couple of other things as well. It’s not only everything you just said and I already spoke about, which is true, but we would also open up opportunities where there aren’t [inaudible 00:21:28] For example, there are communities all over, including the city I live, in Chicago, that have veterinary deserts for miles in certain neighborhoods in our city that I live in, but cities urban areas all over the country, there aren’t veterinarians practicing. So having the opportunity to speak like we’re speaking now online, to do virtual care would provide some comfort and some level of credible care for those folks. There are people all over America that live 80 miles away from a veterinarian, that’s a small animal veterinarian per se that might live in middle of Iowa but not near an urban center in Iowa, and therefore not near a veterinarian. So this technology, which isn’t all that technical really anymore, it will help other people as well.

Dr. Andy Roark:
Okay. So here’s what I want to do, because I’m on board with this, I want to hand you the Cone of Shame magic wand that I have here on the podcast, and I want to give it to you, and I’ll say, “Steve, now, using this magic wand, meaning you could craft this in the way that you like.” You can say, “Optimistically, this is what I would like to have happen.” Can you use it and then tell me what that medicine looks like in five years? And just say, “If I have my magic wand, if I could build this system the way that I want it to be,” given everything that we’ve laid down so far in this conversation, Steve, help me see that vision in your mind. What can this look like?

Steve Dale:
It’s been said that millennials, which are driving veterinary care and services around America of all kinds because so many… That’s where the numbers are at, that’s where therefore the money is at, and as I said, veterinary medicine is a service industry when it comes down to it. So what I would do is do what the millennials want, not only because they want it, because it’s the right thing to do, and it should be done. It’s not a difficult thing to do. One more thing, millennials, it’s been said, aren’t going to be loyal. That actually is not true. If you can show them that you can respond the way they want responses to them, and we’re talking about changes in communication patterns. So if we can provide virtual care in any way by credible individuals, veterinary professionals, any way whatsoever, whether they have a relationship or not with that veterinarian, that’s one thing.
And then the second thing is to use technology like texting. I’m not even sure that I would call that technology anymore. Using portals, which as I say, other medical professions have been using for a while, even predating the pandemic, using what is available to communicate the way in which pet parents want to be communicated. And at the same time, you are relieving yourself, you are making life easier as a veterinary professional for yourself. You are pleasing technicians because you are giving them work to do that they’re qualified to do and they’re doing it. You’re not doing it. That’s better for the practice.

Dr. Andy Roark:
I love that, buddy. I think that’s such a beautiful vision. I like where your head’s at. I like how you’re thinking. What are the biggest pitfalls that you see for vet medicine going forward? Where do you think our profession or individual practices, what are the mistakes that they’re likely to make or that would be disastrous in your mind given the vision you just laid out?

Steve Dale:
I’d like to think that’s not going to happen. The mistake would be to not pay attention to anything that I am talking about, not because I’m talking about it.

Dr. Andy Roark:
I agree. The biggest mistake people make on the regular is not listening to me. I’ll tell you that. My wife makes that mistake all day every day, and it’s sad.

Steve Dale:
No, I would not say that about my wife, because we’re going to be married 30 years and I want to keep it that way. I think that I know that the profession has grand plans for doing all sorts of things like creating a new position that would be this mid-level position, which would be in human medicine, it would be a… Help me.

Dr. Andy Roark:
A nurse practitioner.

Steve Dale:
Yeah, nurse practitioner in veterinary medicine. Whether that’s good or bad, it’s not happening tomorrow, I have a view about that not being so good, but let’s worry about that later. It’s not going to happen now anyway. It can’t. It can’t happen that fast. To add more veterinary schools, to add larger classes to veterinary schools, that is actually beginning to happen to go into primary schools and encourage people in all neighborhoods in America to go into veterinary medicine or teaching humane education. [inaudible 00:26:50] all these plans that are wonderful that aren’t going to change or be of any rescue to the profession today, to pet parents or to professionals, and what I’m talking about veterinary professionals could do today, literally.

Dr. Andy Roark:
I think that’s great. I love that. So to summarize the point, the biggest pitfall is not getting serious about the service that we’re providing right now that pet owners are demanding, I think that’s a great point, I think that’s a great word of warning. Steve Dale, you are amazing. I love your energy, I love getting to talk to you, I love hearing your ideas and how you look at the profession. Where can people find you? It’s not hard, you’re everywhere. What are your favorite platforms and places for people to connect with you?

Steve Dale:
My favorite is my own website. So I write a blog post pretty much every day, stevedale.tv. And you can find me in social media, wherever your social media is. And I’ve not been on TikTok until recently. We now with a kitten who’s no longer a kitten, he’s a year old, and I thought, okay, Groucho, that’s the kitten, ought to have a TikTok page, so you could find groucho_thefunnycat on TikTok.

Dr. Andy Roark:
groucho_thefunnycat on TikTok.

Steve Dale:
_thefunnycat.

Dr. Andy Roark:
Thanks so much for being here. Guys, thanks for tuning in. Take care of yourselves everybody. Hope you enjoyed the episode. And that is our show, guys. That’s what I got. I hope you enjoyed it, I hope you got a lot out of it. Thanks to Steve for being here. As always, if you enjoyed the podcast, share it with your friends and or leave me an honest review wherever we get your podcast, that’s the nicest things you can do. Anyway, gang, take care of yourselves. Be well. Enjoy practice. I’ll talk to you later. Bye.

Dr. Brian Bourquin joins the podcast to discuss the new NOMV C.L.E.A.R. Blueprint. This is a hospital wellness certification program that was recently introduced to veterinary clinics.

Dr. Bourquin talks about the certification, the experience of implementing it in his own Boston veterinary practices, and lessons learned along the way.

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

LINKS

CLEAR Blueprint: https://www.nomv.org/clearblueprint/

NOMV Homepage: https://www.nomv.org/

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

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

Dr. Andy Roark Swag: drandyroark.com/shop

All Links: linktr.ee/DrAndyRoark

ABOUT OUR GUEST

Fueled by childhood dreams of being a keeper at his own zoo, Dr. Brian Bourquin realized from a young age his path – a career in veterinary work. His journey began with graduation from Cornell University, the No. 1 school in the U.S. for veterinary medicine. After 13 years as a Boston veterinarian, he founded Boston Veterinary Clinic in 2012, placing an emphasis on trust, compassion, and top-level patient care. Embraced by the pet-loving community and with the aid of like-minded veterinary professionals, the practice has grown to 5 locations, each focusing on the best medicine possible with accreditations from AAHA, Fear Free, and Cat-Friendly Practices.

EPISODE TRANSCRIPT

Dr. Andy Roark:
Welcome everybody to the Cone Of Shame Veterinary Podcast. I am your host, Dr. Andy Roark. Guys, I’m here with my good friend, Dr. Brian Bourquin today. Brian is here to talk with me about the Not One More Vet CLEAR Blueprint. This is a certification that has been rolled out for veterinary hospitals around workplace wellness. I think it’s really interesting. They have put these modules and trainings together with the help of people from a lot of different industries with a lot of different expertise.
I am a big fan of getting wellness into our practices. I want to keep our people healthy and happy. I want to keep them enjoying medicine. As Brian says, one of the biggest values of something like this is the retention benefit. The chances of keeping our staff are increased when we take care of our people. Anyway, Brian is an awesome guest. I am just such a big fan of his. He is super transparent and vulnerable in this interview, which I love.
He talks about the experience of doing the certification with his practices, what people are on board with, what they were not on board with, areas that his practice soared, they found out what needed to change their game, and he talks about what that looked like and what they did. Honestly, it’s a great conversation. I really think you guys are going to enjoy it. 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. Brian Bourquin. How are you, my friend?

Dr. Brian Bourquin:
I am great. Yourself? So good to see you, Andy.

Dr. Andy Roark:
It’s good to see you as well. You and I have known each other for years now. I think I met you back in 2017, 2018. It was the first time you and your partner Paul came to Uncharted, the vet conference that I run. We got to meet and we’ve been friends ever since. You are doing fascinating things right now. You are doing some work with… Actually, let me just pause here. For those who don’t know, Dr. Brian Bourquin, you are the co-founder and chief Vision officer at Boston Veterinary Clinic.
You are on the board at Not One More Vet or NOMV as it’s known in the profession. You’re also on the board for the Massachusetts Veterinary Medical Association. You are doing a lot of things, and you and Paul were really instrumental in a new program that Not One More Vet has put out called the CLEAR Blueprint. It’s a type of certification for practices. I wanted you to come on. I just wanted to talk with you about it. I’m really interested in what you’re doing. Let’s just start there. Can you lay out at a high level the CLEAR Blueprint? What is it? Who’s it for? How did it get started?

Dr. Brian Bourquin:
Sure, sure. Thank you for that great, great intro. We basically think of it as a workplace wellness certification program. This came out from a brainstorming session of where did we want NOMV to go. NOMV had a very grassroots beginning as a Facebook support group and then more from there. One thing we thought is this is great that we’re making change from the inside. We’re not just surviving anymore, we want to thrive. What if we gave some tools or gave ability for clinics to empower themselves, and through that they can actually, one, use it as a recruitment tool.
It could be a resource for other clinics who want to say that they prioritize wellness in their clinics. That’s where the idea was born. And then we came up with the five, the letters of CLEAR, compassion, listening, energy, action, and resources. Because one of the things that we found is that this is not a brand new idea as far as well-being, but the network or the blueprint, if you will, to actually put that into action is what’s been missing. You can tell people, “Hey, yeah, you should take your lunch breaks and use the bathroom and be nice to each other.”
But if you’re not giving them the tools or resources to do that, then it can actually just become another stressor, like, “Oh, now someone else is telling me what to do.”

Dr. Andy Roark:
Oh man. Well, let me stop and I just want to gush at you for a second. I love this so much. One of the concerns always with something like NOMV that comes from social media is you say, this is good and I appreciate the spirit here. Does this translator or how does this translate into actual implementation on the ground in practice, getting people where they really need to be in their work life? I love that you actually taken this and started making these tools. The other part is I really try to beat the drum for mental health and mental health awareness in our profession.
It’s a big deal. I often roll around with that question of, how do we go from noise in the air down to the actual inside the practice? What nuts and bolts tangible change? Brian, you guys are building something that actually does that. You’ve got some real metrics. You’ve got some real programming. You’ve got some check boxes. And also I think you’re spot on with the idea that there is danger about raising awareness, awareness, awareness, awareness without rolling over into actual implementation.
I do agree, it feels like take your lunch breaks, things like self-care, and at some point you go, “Guys, it’s more stuff I’m supposed to be doing.” I don’t know, it’s another thing that I feel like I’m failing at every day because it’s too nebulous and it doesn’t get onto my calendar and I don’t know I what done looks like. All of those things are reasons I just got really excited when I was learning about CLEAR Blueprint. Start to unpack it. I love it. I love the fact you have the acronym, you have these resources.
Can you start to paint a picture for me of what these resources look like in the practice? If I was going to go to a practice owner or practice manager and be like, “Hey, I’m really interested in this CLEAR Blueprint,” they would look at me and say, “But what does this really mean? What does this look like in our practice?” Can you start to lay down what that structure looks like and what people could anticipate if they were to get involved with this?

Dr. Brian Bourquin:
I’m going to come from two different angles, as a practice and myself. If someone were to come to me with this, there’s two paths. There’s the financial path, if you will, and then there’s the more wellness, well-being. The two we know actually often very tightly well, but those are the two paths. One, this is about retention, retention, retention. We know that there is a mass exodus from the veterinary profession on all levels. We got to slow that flood from leaving. We all talk about what our bonus packages are and our moving packages and all the things we do to get an employee.
But sadly, and I include myself in this in the past, we didn’t do as much to retain them. If some were going to come to me, the first thing I’d be saying to a practice owner or practice manager is this is about retention. This is about keeping the people that we want, the people who fit our culture, the people who if we could mold someone, this is what we look like, let’s keep that person, because we’re not doing a good job of that. We’re losing to other careers and just completely out of the veterinary professional altogether.
And then the other, of course, is more well-being. We know that happy, not depressed, sleeping, eating, using the bathroom are going to be better employees. They’re going to be nicer. What are they going to do? They’re going to do a better job at their life goal often is helping animals. That’s why always going to remember, why are we here? What are we doing? We’re here to help animals and help the pet parents. They’re going to do that better if they’re feeling…
And then lastly, this is slipping the other way, I would say it doesn’t have to be the practice manager or the practice owner that is being brought this. I would talk to my other practice owners and say, “Bring this to your staff.” What better way to say, “Hey, I’m going to put my money where my mouth is.” And we did this. We were one of the betas. I’m glad we passed. That wouldn’t look good. But we say we’re going to put our money where our mouth is.
If we’re going to be board members of NOMV and we’re going to take part in the 5K and the race around the world and all these things and make the t-shirts and the shoes and do all the stuff, are we actually doing that within the clinic? It’s a little scary. Thankfully, we did pass.

Dr. Andy Roark:
Sure!

Dr. Brian Bourquin:
When you look at the different modules, there were modules that we didn’t knock it out of the park. And that was a sobering moment. But that’s the good thing about this is that it’s just not a big pat on the back. This is an ongoing living program. You’re going to look at those areas where maybe you didn’t do as well and say, okay, well, what’s my 10 step plan, or when am I going to regroup and look back at this again?

Dr. Andy Roark:
Well, I think it’s really a positive you didn’t knock it out of the park. I mean, as you say, if you go in for a certification and you just breeze through everything, it was probably not actually going to make you any better. It’s just funny, in my business in the last couple of years, I’ve really looked at that and there’s areas where we struggle. We’ve had to pick it up and go, “Oh man, this is not something that we’re great at.” It’s humbling, but then also you go, “Well, wait a second, this is how we continue to grow and get better. We should always be challenged.”
Brian, put your practice owner hat. Just keep it on for me for a second, if you don’t mind. Walk me through that experience. You go to your team. You’re like, “Hey, I’ve got this thing.” How did you explain it to them? What was their reaction? Were they like, “Yes, we want another thing to do,” or were they just like, “Well, he’s really excited, so we’ll just do it?” How did you talk to them about it? What was their reaction to doing something this?

Dr. Brian Bourquin:
I leaned heavily on the clinic managers. For those who don’t know, we have multiple clinics. I’m not necessarily as well-known as I was at one point where I knew everyone, so I relied on the clinic managers for help. We basically said, we want to take this assessment. We don’t like to say test. No, I swear the word test. We’re going to do this assessment of different areas looking at the clinic health, the wellness health. What we’re going to do is we’re going to take your input, of which you had to have 80% involvement.
You can’t just have three people saying, “This is what I think.” It isn’t Paul, myself and one clinic manager saying, “Oh yeah, we’re awesome. We’re great.” It’s anonymous. We only had to do one reminder. The first batch of people who came in, and then we had to do one more like, “Hey guys, we have to get over this threshold to be appropriate for the accreditation.” So then it went to the panel of people who look at the assessments and we got our score back. I’m going to just give an example of a place where we had to do better.
One was financial stability. Of course, as a practice owner, I was like, oh my god, they don’t think they have a good business. No, that actually wasn’t what it was at all. It was their own financial stability at the Boston Veteran Clinic living in Boston. I don’t ever think CLEAR Blueprint should be used in a silo. I actually use this alongside a DEI exercise. One thing we found is especially people of color living in Boston, they were struggling. They were paycheck to paycheck and really worried about what would happen if kind of thing.
One of the things that’s led to my long-winded story here was we actually gave a $2 raise across the board that went just to them. I’m sorry, let me back up. We raised exam fees $2. Instead of that being like a dollar for me, a dollar for this, it all went to the staff. We were actually able to take this thing that they could be honest with us through this anonymous platform and actually make a real change. I now have 100 employees. It wasn’t for salary, but now these people are feeling a little bit better.
And that shows. I mean, what else can show that your practice cares about you than a raise that goes just to them that came out of something that they brought to your attention?

Dr. Andy Roark:
There’s a number of things I want to grab onto here because this is such a great story. I love how you put this tool into that practice and how you rolled out the staff and how you got involvement, and then how you made changes based on the experience of the staff and with the information that came back to you. I think that’s just how it’s done. I think it’s a beautiful story. If you dream of doing team training with your team, getting your people together, getting them on the same page, talking about how you guys work together in your practice, I’d love to help you.
You can check out drandyroark.com and check out the store. I have two different team training courses. These are courses for teams to do together to get on the same page and to talk about how you do things. I have my angry clients course and I have my exam room toolkit course. They are both available there to come out. All right, guys, let’s get back into this episode. What was your experience? You do this, you see the financial stability, and you say, “Oh, we’re in Boston. A percentage of our staff is really feeling this way. This all makes sense. We’re going to raise our exam price and then put that into staff wages.”
Did you feel like you got exceptional buy in to that from the team? Were they like, “Yes, this is what we want?” Usually whenever we adjust prices, there’s people who push back. What’s your feeling on that as far as being on board with the changes?

Dr. Brian Bourquin:
We definitely made it known that this was for them solely. We were not raising prices. We sent it out to our clients out. We said, “Hey, these prices are going up and this is the reason why, because we just came out of COVID and we got our butt kicked twice.” We shared that with the clientele, which was interesting because as we often know, our clients don’t really know. They used to be suffering in silence. They don’t know what’s happening to the vendor. Oh, don’t you just play with puppies and kittens all night? Well, no, there’s more to it than that. That’s a whole other separate story, but basically that’s where NOMV came from was the suicide crisis in veterinary medicine.
It changed the tune of the clientele a little bit, right? I mean, it felt like they were a little softer with our staff, that they were just a little bit more realizing the struggle that they were going through. But we already know. From the same thing, we know that our employees say that without their discounts, they couldn’t afford our services. That’s the other area that we’re looking at, which if you ever looked at pet insurance for a big company, that’s a headache in itself. One thing I do have to say, because I’m going to get in lots of trouble if I don’t, is that this program is sponsored by Merck.
Merck actually underwritten the whole program and I would get in big, big trouble if I did not recognize that they’d been a great partner from the start. This program morphed initially, which was going to be kind of this one-time accreditation to now ongoing resources, staff members. This was originally going to be a free program, and we realized quickly, oh, you can’t do that if you’re going to have staff and stuff. Merck has just been an amazing partner and my hat goes off to them for their help.

Dr. Andy Roark:
This episode is not brought to you by Merck.

Dr. Brian Bourquin:
No, it sounds right.

Dr. Andy Roark:
But I just have to say, I saw Merck as the founder and supporter. This is CLEAR Blueprint powered by Merck as I saw it. They also have been a huge force behind initiatives like mentorship. I’m a big fan of Addie Reinhardt and her mentorship program. It’s like, man, Merck has done some exceptional things fairly quietly for our profession. I think just stopping for a second and giving them a big shout is absolutely warranted.
What does the actual implementation look like in your practice, Brian? Are these team trainings? Are they on demand, asynchronous learnings where people do it as they’re able to? What does that look like when you started bringing this?

Dr. Brian Bourquin:
Exactly, exactly. What we’ve done is tried to not have just a one size fits all. To our earlier talk about telling people you have to take breaks and you have to take lunch in a day that you don’t have time, one of the things that we did not want to do with CLEAR Blueprint, which is throw something at someone to add another thing. Currently, we’ve had 24 clinics that are accredited, including mine. We have 28 that are enrolled that are slowly going at different stages, because it is a self-taught program.
The resources go anything from just your initial let’s talk about financial stability to you can dig deep with research. We actually even brought in financial planners as part of something that, heck, I didn’t know, as part of our retirement benefits thing. You get to use financial planners. Now, a lot of my staff weren’t necessarily ready to start investing in the stock market, but they could actually have some conversations about, hey, can I afford a car? What would this look like if I actually put down money for a home?
When did you ever have that earlier in life? I mean, I didn’t. That was not something that anyone ever did to me. And then there’s 23 other clinics waiting to be onboarded. The ones that have already got their accreditation, our goal is now that that starts to be a network. Say someone takes it and maybe they don’t pass the first one because they’ve got three clinics. One of the hardships when you’ve got multiple clinics is maintaining that culture across what happens when you’re not there?
What’s happening when I’m not in Brookline and I’m at the Bay Village Clinic? One of the things that we can now do is the people on CLEAR Blueprint can say, “Well, you know what? I think they’re struggling from a similar problem that Dr. B, he and the Boston boys, handled in Boston. Let’s put them together and help them work together.” It’s same thing, some of the hardships of more rural vets are not going to be the same hardships I have. I would not necessarily be a good peer partner for them, but maybe we take someone else who is in a rural background.
There’s modules. Some examples of the training modules that we have are building trusting teams, emotional balance. I talked about financial stability. Community relations, this is one that Paul and I worked really big on. One thing I have failed in all my talking here to say is this wasn’t just vets, which is really important to say. This was a multidiscipline professionals. We had business owners. We had veterinarians. We had vet techs. We had mental health professionals. We had social workers.
This wasn’t just a bunch of practice owners who were saying, “This is the way the clinic has got to be.” The same thing for the workshops. We were taught different ways of teaching. The traditional teach at you type of thing doesn’t necessarily work. They actually built some of the modules out that way too to work for different types of people. There’s videos. There’s reading. There can be discussion. As long as you’re accredited and you’re up-to-date on your dues, you actually can use any of the NOMV resources, which is a pretty big organization.
There was a lot of blah, blah, blah there, but I think I hit all the different points of how you can utilize this. But this definitely is not just a one touch point thing. It’s like you take your test, you’re accredited. And then there’s re-accreditation, which we’re brand new, so we’re not to that point yet, but we want to make sure. Because just like we’ve noticed with… I’ll use AHA or Fear Free. As their sciences and they continue to evolve and there’s better ways, I’m sure the same thing’s going to happen with CLEAR Blueprint.
We’re going to find things that, oh, well, maybe that isn’t the best way to handle financial stability. I’m going to make up something, but bringing in Investor Bro to your own staff. Shame on you. Know your audience. Instead, you could have done this. These will be living modules that will continue to grow. For example, I’ve already been asked to produce a webinar series on community engagement because that’s something that we… Any event we have always has got a give back to the community component to it. I will do a living breathing module about how I do that here.

Dr. Andy Roark:
If you had to look at the course curriculum, Brian, and put your finger and say, “I think this module, this topic, this subject is going to have an outsized impact on most veterinary practices,” what module would you pick? Are there things that you feel like that are really weak spots for a lot of practices or real opportunities to jump forward that practices aren’t aware of?

Dr. Brian Bourquin:
Yeah. I mean, I would say building a trusting team. I mean, this is one of the places where I shame myself. When we first started the company, Paul wanted to spend all his time on culture and mission statements, just all this stuff, and I just wanted to be a vet. It showed because we didn’t have a cohesive team. Uncharted can speak to this, but it’s really doing your homework and seeing… Something else we’re going to do is we’re actually going to revisit our mission statement because it’s what Paul and I came up with when there was five of us in one clinic.
Well now that we’ve got five clinics and 100 employees, maybe we should ask them what their mission statement is, what they like to see our culture and values look at. I think that’s key. Because if you don’t have that, that’s what everything else is wrapped around. If you can’t get your hands around that, then you’re going to struggle, and I don’t know how you could get to any of these more advanced platforms.

Dr. Andy Roark:
Yeah, no, that makes a ton of sense. I totally hear the old, do we really need to spend this much time on culture and mission statements and things? I get it. As a pragmatic problem oriented person, I get it. Are there pitfalls that you see for practices who are like, yeah, we want to pick this up? Are there ways that you could see people or have seen people stumble rolling this out to the team, communicating about it? How do I shoot myself in the foot if I had the best of intentions and want to get my practice on board?

Dr. Brian Bourquin:
What places that we’re seeing some struggling is with, and I’m not going to pick on the corporates, but corporates is a little hard because you’ve got a network. You may have one practice manager at this clinic who really is behind wellness and someone else who maybe is just struggling to get through each day and they don’t feel they can worry about wellness. That’s one area. There’s a time commitment to this. We’re giving this to teams of overworked people who are trying to be the best them, but they got to sleep sometime and they got to go home and walk their dog.
We’ve seen some of the how long the program was going start to get a little long in the tooth. That’s where we just regrouped. And then also the idea that this is going to be an ongoing program, that this is not a one-time thing. If you get some staff turnover, which may be a good thing, I mean, some of this is if you don’t get enough buy-in, you maybe need to look at your team. Is it a lack of a mission statement, or it’s just are you not all on the same mission? But that can also make it harder.
I mean, we’ve all dealt with “the toxic employee” and you do that, well, at least they’re human, at least they can hold a dog. Maybe they’re not good at it, but at least they can do it. Those kind of things. When you do lose some of the people from this, you could almost look at this and be, “Well, I liked it better before we accredited. Now, I’m working twice as hard.” You just got to weigh that like, no, guys, the long term goal here is we’re going to retain you because this is going to be a good place to work. Hang in there with us.
But we found that the team buy-in just because we brought this to them that we were already ahead. We already went to the plus column with the team buy-in because we’re being so proactive with this.

Dr. Andy Roark:
Well, I really like that point about expectations. Programs this fall into the important, but not urgent of the Eisenhower Matrix. I think most of the most valuable things in practice are important, but not necessarily urgent. They’re not on fire. No one’s like, “Oh my God, we have to have that certificate now!” But those are the things that make the practice. It’s always a battle to keep people engaged and say, “This is important. I know it doesn’t have a deadline that’s tangible sitting on top of us, but we’ve got to keep working.” I think motivating people that way has got to be top of mind.
And then the idea that this is not a, hey guys, we’re going to get workplace culture sorted out in the next six weeks and then we’ll be done with it. People, they don’t really want to hear that. They want to believe, yeah, we’ll be done. I think setting that expectation up front sounds like a pretty smart move. Brian, where can people learn more? I’ll put a link down to the CLEAR Blueprint information page in the show notes. Other places that they should go to get information? Any resources you would recommend?

Dr. Brian Bourquin:
NOMV.org. That’s our major parent site. CLEAR Blueprint has its own own area. You can actually go right to the /CLEARBlueprint. There’s a site there that you can apply right then and there, and then you’ll start filling out your information. Having an advocate is key for this. I should have mentioned this before. I was not the advocate because I was going in too many different directions. You’ve got someone who’s on the ground, who’s going to actually be taking care of this. You would get your clinic advocate to apply, and then they’ll get you lined up to get the process started.
There is a fee, which I want to say that just to be completely transparent because of the need for staff. It’s 499 to 899, depending on the size of your clinic, because there’s more work when there’s more people. But there are scholarships available. If you’re finding that your clinic that’s struggling because your team is not cohesive and everyone’s quitting, or maybe you don’t have an extra grand laying around to pay for programs, we do have scholarships available for that.

Dr. Andy Roark:
That’s outstanding. Thank you so much, Brian Bourquin, for being here. You are amazing. Thanks for the work you’re doing with NOMV. Thanks for telling me about CLEAR. I’m looking forward to it. Guys, take care of yourselves, everybody. Be well. And that’s it, guys. That’s what I got for you. I hope you enjoyed it. I hope you get something out of it. As always, if you enjoyed the episode, one of the kindest things you can do is share it with your friends or leave me an honest review wherever you get your podcasts. Guys, take care of yourselves. Be well. I’ll talk to you later on. Bye.

Dr. Tannetje’ Crocker joins the podcast to expand on a previous episode where she and Dr. Roark discussed the ethics and implementation of intentional discounting. In this episode, Drs. Crocker and Roark talk about the feedback from that episode, what they see as valid criticism and what they disagree with.

The conversation then turns to a larger perspective on supporting pet owners who struggle to avoid finance, and the realities of working in a corporate emergency practice vs owning an independent clinic.

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

LINKS

Follow Dr. Crocker’s veterinary journey @dr.tannetje.crocker or www.drcrockerpetvet.com

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

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

Dr. Andy Roark Swag: drandyroark.com/shop

All Links: linktr.ee/DrAndyRoark

ABOUT OUR GUEST

Dr. Tannetje’ Crocker is a 2009 graduate from the Texas A&M University College of Veterinary Medicine. She is passionate about mentorship and empowering veterinary professionals to embrace the profession and find joy and success. Growing up Dr. Crocker competed on horses and was inspired to become a veterinarian. Since graduation she has worked as an equine ambulatory vet, small animal general practitioner, and emergency veterinarian. She currently lives in Texas with her spirited 10 year old daughter, funny 6 year old son, and supportive husband of 16 years.

She works as an ER Veterinarian for Veterinary Emergency Group in Dallas, TX. Recently she was excited to purchase Alta Vista Animal Hospital in Fort Worth, TX. She plans to continue her support of fellow veterinary professionals, both virtually and in person through her various endeavors.

EPISODE TRANSCRIPT

Dr. Andy Roark:
Welcome, everybody, to the Cone of Shame Veterinary podcast. I am your host, Dr. Andy Roark. Guys, I got a great one here, Dr. Tannetje Crocker’s back on the podcast. The last time she was on, we talked about intentional discounting, and we got feedback on the episode and we get into it. Yeah, there was some pushback on jumping in in sort of the conversation we had about discounting services and things like that, and it stuck with me and I felt like I didn’t do that episode necessarily justice and the way we set it up, and there were some disagreements I have with some of the criticism it got. I talk about that in this episode.
Anyway, yeah, I put it out up front and say some of the criticism, I didn’t agree with, and I’ll talk about why. Some of the criticism, I think it’s totally valid, and that’s sort of on me and the way I sort of set our conversation up. We talk about that. Guys, ultimately, this becomes a life and philosophy conversation. I really love this episode. I talk to Tannetje a lot about the differences she sees in working for a corporate emergency hospital, and also running her own hospital. She’s an independent practice owner. We talk about what her aspirations are and why she went into practice ownership, and how she does both of those things, and just philosophically what she’s trying to accomplish.
Guys, I think it’s a beautiful conversation about spectrum of care. It’s a beautiful conversation about what do you want your career to be? What’s important to you as an individual? Just, man, I love where this conversation goes. I hope you guys will really enjoy it. 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. Tannetje’ Crocker. How are you?

Dr. Tannetje’ Crocker:
I am good. I’m here. I’m excited I made it this time, so thank you for the grace.

Dr. Andy Roark:
Oh, gosh. No, you are amazing. Okay, so first of all, you say thank you for the grace, and you shouldn’t have to say that. For those who don’t know you, first of all, you’re a social media personality. You do a lot of stuff online, and you are an emergency veterinarian at a big corporate emergency practice that most people know. You are a new practice owner as well. You have how old, you have one child in kindergarten?

Dr. Tannetje’ Crocker:
I have two. I have the kindergartner, and then a fifth grade daughter who is 11 going on 25.

Dr. Andy Roark:
Yes.

Dr. Tannetje’ Crocker:
She’s great, independent.

Dr. Andy Roark:
Yeah.

Dr. Tannetje’ Crocker:
Good to go.

Dr. Andy Roark:
I remember my daughter hit 11 and became a 22-year-old. I think that for me, that was definitely the age where the switch flipped. There was eye rolling at Dad. I was much less cool, but it was fake. It was like, “I’m going to pretend like Dad’s not cool, but I know he still is.” We’re tight, but I have to be cool about it when her friends are around.

Dr. Tannetje’ Crocker:
Yeah, when they don’t want you to come eat lunch with them anymore at school, that’s like, that one hurts little, but she’s like, “But I have my table with my friends and we need to hang out. That’s our hangout time.” I’m like, “What?”

Dr. Andy Roark:
Yeah. You’re like, “Oh, pardon me. Let’s see if I can get on your schedule sometime in the future.”

Dr. Tannetje’ Crocker:
Yeah, your social calendar.

Dr. Andy Roark:
Oh, man. Yeah. Well, so that’s what I mean. You have so many things going on. I appreciate you making time. I always love talking with you. You and I have talked many times. We’ve had many adventures together.

Dr. Tannetje’ Crocker:
Yes.

Dr. Andy Roark:
I think the world of you. I always love your perspective. We did a podcast a while back on intentional discounting in emergency medicine, and it got some feedback. We got in trouble. We got in trouble.

Dr. Tannetje’ Crocker:
We did.

Dr. Andy Roark:
We did. We got in trouble. I wanted to, but I, as someone who just can’t leave things alone, as I sat with this, so okay, so we put up this podcast, you and I did. It was on intentional discount, and we talked about doing discounts to make things accessible when people come in in an emergency. I think there was one thing that I, as the host, did not set us up for success. I jumped right into discounting. I was like, “All right, let’s just talk about discounting.” Whenever you talk about discounting, you have to talk about the larger framework of helping people get access to care.
I drove us straight into, “Let’s jump right into this thing.” I just didn’t set it up very well or very clearly. People are like, “Oh, Andy’s saying and Tannetje’s saying that the first thing we should do is cut our prices when people walk in.” I go, “Well, I did not mean to imply that, but by going straight into that conversation, I can see how I led people to believe that.” I wanted to walk back out and sort of lay some of this groundwork that I should have laid the first time, sort of make this into a larger conversation. The other thing was I got a significant vocal pushback on one point that I just don’t buy into.
There were some people who just took issue with the concept of discounting. They were like, “How dare you talk about discounting when we are not paying our staff what they should be making?” I wrestled with that a little bit for a while, but I don’t buy into that criticism. I just want to sort of address that up front before we start to lay down the groundwork. I do think this is really important whenever we start talking about access to care. It’s my perspective that yes, two things can be true at the same time. We can have a situation where support staff don’t get paid what they should get paid, and at the same time, refusing to help people get access to care, I believe, will burn people out faster than not making 10 cents a day more if that was converted into wages.
I’m not trying to blow it off or anything, but I think that that was an interesting criticism in that it was very much looking at how we provide care as a zero-sum game, which means if I discount things, if I drop the price, if I change how we deliver care, then that’s a loss for the staff. If I want to win for the staff, I have to be inflexible to the pet owners. I go, “I don’t think those things are true. I don’t think anybody wants either of those scenarios. I think we all want to find the balance between them.” I don’t know. You were there. You saw the conversation.

Dr. Tannetje’ Crocker:
I saw it.

Dr. Andy Roark:
Do you agree with that?

Dr. Tannetje’ Crocker:
No, I agree. One, I would say, I was surprised by the criticism. I never even had that thought in my head that people would automatically jump to, “Well, you obviously don’t pay people enough if you discount.”

Dr. Andy Roark:
Yeah.

Dr. Tannetje’ Crocker:
I think that for me, reading through the comments, it stemmed through personal experience. It seemed like a lot of these people did work at practices, where veterinarians, a lot of times, to avoid conflict or not to upset pet owners, just gave a lot of stuff away for free, with no intention behind it, and no real understanding of why they were doing it. They weren’t being paid enough. In their mind, if things were charged appropriately, they would get paid more. I can see where that would be the perception.
Now, I work for a very large corporation that has 40 plus locations, where, as a culture and a team, we have decided that this is something that we want to do. It does help us overall, working in the ER especially, to want to go to work and to help pet owners that we think really deserve the help in pets that we can truly save, if we can find a way to work with them.

Dr. Andy Roark:
Yeah.

Dr. Tannetje’ Crocker:
I have given this talk a couple times at conferences since, and I think you’re right about, I really have to lay the groundwork of, we already discount, we’re just saying, let’s bring it into the light what we’re doing.

Dr. Andy Roark:
Yeah.

Dr. Tannetje’ Crocker:
Let’s have intention behind what we’re doing, and as a team, this is not the doctor deciding, this is as a team, we have decided that we want to help as many pets as possible. Sometimes, that means we give something away, or we reduce the price on something, or we do plan B or C because they can’t afford plan A. I sleep better at night knowing that, and I know that my team does too. I agree. We had a very short podcast to talk about something that is really a huge issue and there is a lot of gray areas to it.
I’m glad we’re getting a chance to clarify a little bit. I work for a corporation that pays extremely well, and we also discount. You can’t say that discounting alone is the reason why people are not paid a livable wage in our profession.

Dr. Andy Roark:
Yeah. Well, I think you put your finger on something really important there too is you say, “Well, I feel good about, it and my team feels good about it.” I think that’s a really important part when we start talking about things like spectrum of care, and how we’re going to get people access if they just can’t walk in and stroke a check for gold standard of care. I think one of the things that I didn’t realize earlier in my career is how important it is to have the open conversation with the team. I don’t think that’s modeled very well.
I think that the idea of bringing the team together and saying, “Guys, can we all agree that getting care for people is important, yes or no?” Even starting wider than that and saying, “What do you guys enjoy about your job?” I think that people saying, “Oh, being the hero, really, it means a lot. I want to help people.” I think if you start out wide and say, “Okay. We all agree that we want to try to be able to make care happen, and that you guys getting paid a good salary is also important.” I think you can end up doing what a lot of practices already do, which is try to find a healthy balance. Everybody feels like they feel included, they feel heard, they feel like they were there when the decision was made.
I think you really put your finger on it when you were like, “Oh man, imagine being at a practice, and you are not getting paid what you should get paid, and you see the doctors just giving stuff away, and you’re not involved in this transaction at all.” You’re there trying to do the gold standard of care to take the history you’re supposed to take, to help support, provide the best standard of care possible. With no input, not even a, “Hey, is this okay with you,” sort of head nod. You are seeing things go out the door and you’re going, “Man, I’m struggling financially here, and I’m having a hard time with this.”
I didn’t realize that as a leader, how important it was to take the time sometimes just to make sure everybody’s on board, and how much smoother everything goes if you take the time just to talk it through with the staff.

Dr. Tannetje’ Crocker:
I do think that you can go too far to the extreme and be the practice that gives everything away, and that sets you up for failure, or you can be the practice that never works with people, and you make your team say no all the time, and they just get completely raked across the coals because of it. To me, there’s a happy medium, but it is the conversation and these are businesses.
To me, it’s also following up, looking at what are we discounting? We have these conversations within our business where we say, “What are all the doctors discounting? There’s kind of an average we expect, some are a little higher, some are a little lower, but as a hospital, we know this is about what we’re going to discount on a monthly basis. Are we still paying the bills? Are we still making it work?” “Yes, we are.” “Okay, we’re good.” If someone is excessive in it, then it’s a conversation of, “Why are you giving away so much? Yeah. Are you avoiding conflict?” That’s why I see it a lot of times with young vets.
They don’t want to figure out a way to find a plan B or C. They don’t want to have the hard money conversations. It’s easier to just say, “I’ll just discount that.” That’s really not the purpose in what I was talking about. I’m talking about doing it with intention to either buy a pet time for people to get financial resources, or to get an answer so someone can make a decision. It’s a little different when you look at it as just give it away to avoid conflict, versus there’s a purpose behind it. That’s why it’s called intentional discounting.

Dr. Andy Roark:
I do like that. I think that that’s a good distinction. I really like how you summed that up into the two rules of buying time, so that we can get the resources that we need to do to do the work, and then getting an answer so that we can then, again, make a plan that would lead to the ability for the pet owner to actually reengage, and know how to expend their resources.
Talk to me a little bit about your practice that you own. I’d like to hear a little bit about the different experiences there. We talked last time exclusively about emergency medicine. Do your thoughts feel different? Do they look different between the two practices? Tell me about that.

Dr. Tannetje’ Crocker:
It is extremely different, and it is mainly because I work for a 24/7 high volume emergency hospital where we provide this amazing level of care, and we charge for that care. We charge large numbers. On the other hand, I bought a practice that had been in the community for 35 years, and I am intentionally keeping my prices as low as I can to still pay the bills and pay myself. We are definitely not the highest in the area, because I want to allow people to come there, and feel comfortable with the pricing, and do what they need to do for their pet.
I always told myself if I owned a hospital one day, I wanted to make sure that the people that worked there could actually, if they were a client, afford to bring their pets there. I didn’t want it to be that we were so high-priced that doesn’t make sense that they couldn’t bring their pets there. I have really looked at pricing, looked at margins, looked at inventory. I have been able to give all my staff members raises since I bought it. We’ve been able to provide some additional benefits that they didn’t have before. I’m really trying hard to find the balance between making your team feel supported financially, emotionally, but also really serving the community. That is where my heart is, is really serving, educating, and helping as many pets as possible.
As we get further into what some are calling a recession or seeing the economy changes that are coming up, we need to be thinking about this more and more is, how are we going to make it work, and how are we going to balance it all? It is extreme the difference in the estimates that I give at the ER versus my general practice, but I like seeing the different sides of it and also thinking through what makes sense in each setting. Also, it gives me a good perspective that when we talk about something, you can’t make blanket statements in veterinary medicine.
You have such extremes of where people work and what they deal with. That’s why, again, I’m glad we’re able to talk a little more in depth about something that is not a simple, easy topic in any way, shape, or form.

Dr. Andy Roark:
If you dream of doing team training with your team, getting your people together, getting them on the same page, talking about how you guys work together in your practice, I’d love to help you. You can check out DrAndyRoark.com and check out the store. I have two different team training courses. These are courses for teams to do together to get on the same page, and to talk about how you do things. I have my angry clients course, and I have my exam room toolkit course, and they are both available and there to come out.
All right, guys, let’s get back into this episode. How do you talk to your staff about that? Are they aware that your emphasis on the community is something that’s intentional? How do you introduce that idea to them and say, “Hey,” because this is clearly something you care a lot about in how you’re sort of setting your practice up?

Dr. Tannetje’ Crocker:
Yeah. We have had a lot of discussions about our culture in general. I am big on, I know it sounds silly, but having fun while helping pets. I want us to enjoy what we do. I want us to feel like we’re making a difference, but I want us to help as many people as possible. I’m really big on the client experience, and that includes how we have financial discussions, what options we give people for paying, and how we work through those moments.
We have had quite a few meetings and discussions about that, and about the things that we feel like are kind of the foundation of our culture, because I think it starts there. Then since it is a hospital I bought, it’s been an experience trying to see who’s on board with that and who isn’t. Some people have been, and some people haven’t, and that’s okay, but we’ve had some new team members come in. The people that are there I think have really bought in. Overall, I think we have word of mouth already spreading that we are really trying hard to make a difference in the community and for the pets, but also make sure that we take care of each other.
It’s checking in. It’s checking in frequently, it’s making sure it’s not just at a team review. You’re asking people, “Have you bought in? How are you feeling about things?” It is as frequently as I’m up there, it is really talking to people, getting to know them, and making sure we’re on the same page, and making sure the team is comfortable with the culture and the expectations that I’ve set.

Dr. Andy Roark:
I like that a lot. I also agree. It’s funny, one of my big takes when people ask me to predict the future is to say, “Well, the future of vet medicine is fragmentation,” which means there’s going to be a lot of different practices doing things in very different ways. I think it’s a good thing. I think it’s going to be the fact that some people are really focused on access to care, that doesn’t take away someone else’s dream of having a beautiful Mayo Clinic of that medicine one day.
There’s space for both of those things, and they’ll serve different needs. I love that you have found the niche and kind of moved intentionally into it. Is that what you had in mind when you bought a practice? Were you like, “I want to buy a practice and really approach this accessibility?”

Dr. Tannetje’ Crocker:
I did. I’ve worked at practices that were the more expensive practice, and definitely offered the quality and the client experience that you would expect for the prices. What I hate is when people charge a ton, but then don’t actually provide what they should be providing for that price. I really wanted to make sure that I could take care of the team financially, I could take care of the hospital, and that I could set up an experience that worked for the client and the pets. Less so is it about right now, me trying to take a ton of money out of this business and trying to make money right now. It’s a long game.
It is building something I’m proud of, building something that I think will help the younger generations of vets. I see young vets coming in, externs being there, just really helping, I think, the profession as a whole, along with pet owners. I’ve always seen it that way. I’ve always seen it as a place that my kids could run around, and they do. The holidays are coming up, and they’re going to be up there a lot. There was a certain feel I wanted. I wear boots and jeans to work half the time.
There’s just a certain feel that I needed to go there and to feel proud of it. I feel like so far, I’m accomplishing it. I still have so much to do, but that was definitely my goal. I never wanted to be the fanciest, shiniest thing on the block.

Dr. Andy Roark:
Well, that makes me so happy. I always have this dream of I just want, whether you’re a vet or a vet tech, I want you to have autonomy in your career. I want people to be able to decide how do they want to make a difference in the world, and then to be able to do that. I just love that you had a clear vision for how you wanted to make a difference, and just went after it. Are there challenges that came up that you didn’t anticipate as you started to go this way?
You already mentioned, I thought it was really interesting, some of the team, we bought the practice, and some people got on board, and some people did not get on board.

Dr. Tannetje’ Crocker:
Yes.

Dr. Andy Roark:
That was okay. I would assume that they’re not there anymore. I always say that to people who are at practice that gets bought as well, like, “See what it is. If it’s not your jam, then you should go find a place where you fit in.” I think that that’s a thing that everybody should be comfortable with. Are there sort of other challenges that you didn’t anticipate?

Dr. Tannetje’ Crocker:
I think that was probably the biggest challenge initially, because in my head, my idea of what a practice would be was so great that anyone would want to work there. The idea that someone would say, “I don’t really like change, or I’m not comfortable with that,” or just not be comfortable with the expectations I had for them, that was surprising to me. I’ve had to have a lot of heart to hearts with my husband, who he helps me in the practice, he has a finance background, so he does a lot of things on that side of it, and conversations about not everyone has to be on board with your vision. You need to think five years down the road, who is going to help you accomplish what you’re looking to do, and be okay with that shift a little bit into the owner mentality.
I think that’s been the biggest surprise is as an associate vet, I thought I had it all figured out. I knew exactly what you needed to do to make a practice perfect, so no one ever wanted to leave, so the clients were always happy, so the pets had a great experience. Actually, doing that as an owner, you learn how much you actually don’t know, and how difficult it is to achieve all those things at once, with so many personalities. That has been the biggest lesson. I have the idea, but doing it is harder than I thought it would be.

Dr. Andy Roark:
You’re speaking to my soul. I had the exact same thoughts earlier on this. I have these things that I’m excited about. I know what’s going to be great. I’m so passionate about this. Other people are going to see that this is the best thing and they’re going to get on board. It absolutely rocked me when some people were like, “Nope, that’s not what I want,” and just did not. For a long time, I carried that as a personal failing. I suspect there’s a lot of people out there who do that as well, of, “If I was a good leader, if I was a good boss, then the staff would a hundred percent be on board with what I’m trying to do.” It’s like, “No, that’s not true.”
You can be incredible and have values that are contradictory to someone else’s, or just have things you that you want that the other person does not want. That has been a thing that I have also sort of worked through in my career. Yeah, I love that you called that out. I love the idea of having the long view of where are we trying to go, and having the patience to say, “Some people are going to leave, and that’s okay.” I think that that can feel catastrophic. Did you feel that way when the first people were sort of like, “Look, we’re really not on board?” Was that a dark day?

Dr. Tannetje’ Crocker:
No, I’ll leave it at that.

Dr. Andy Roark:
Nope. Okay. Yeah.

Dr. Tannetje’ Crocker:
Nope, not at all.

Dr. Andy Roark:
Gotcha. No, I’ve seen it. I’ve seen it.

Dr. Tannetje’ Crocker:
I don’t know if that makes…

Dr. Andy Roark:
Yeah. Totally makes sense to me. I, 100%, it depends on how they communicate their unhappiness about the direction. Yeah, I have 100% seen that. I tell you, for me, there has been times when people are like, “You know what? This is not where I’m really excited to go, and I’m going to go somewhere else.” I think it’s about a 72 hour swing for me. About 72 hours, I’m like, “That’s it. This is the first straw to fall. All of them feel this way.”

Dr. Tannetje’ Crocker:
Yeah, it’s over.

Dr. Andy Roark:
The whole place is going to empty out. It’s over. It’ll be me by myself in this building in a week and a half. I think maybe, I don’t know, maybe I got smarter as I got older. Maybe it’s just the fact that I’ve had that thought many times and it never actually happens. Now, I’m like, “Ah, I guess I’m probably going to be okay.” Boy, first couple of times, I was like, “That’s it. Good thing I borrowed all this money so I can go live in the forest by myself.”

Dr. Tannetje’ Crocker:
I think my husband knows me, and he always says, “I will not have a hypothetical discussion. We are not going to talk about what could maybe possibly happen.” That is my brain all the time.

Dr. Andy Roark:
That’s a good piece of advice. Yeah.

Dr. Tannetje’ Crocker:
He told me in the beginning, he said, “What’s the worst thing that’ll happen?” We kind of played it out, and he said, “The worst thing is we fail and we sell the practice, and we’re still going to make money because the real estate is worth so much.” He was like, “Failing is not the worst thing. We’re not going to lose our house. We have our health. You’re going to enjoy it while you’re doing it,” but that helped me. Now, my worst case scenario is still not the worst. He knows me well and knows how to help me, pump me up, but yes.

Dr. Andy Roark:
I’m going to call your husband when I have existential crises.

Dr. Tannetje’ Crocker:
Yeah, he’s good.

Dr. Andy Roark:
Yeah, because that’s exactly what I need to hear. We’re not going to have hypothetical conversations. I need to have that conversation with myself, because I have hypothetical conversations with myself in the shower, and I’m like, “This is not good.”

Dr. Tannetje’ Crocker:
Same.

Dr. Andy Roark:
“We got to stop.” That’s awesome. I love that perspective. Yeah. The other thing that you just said that I really love and have gravitated to in the last couple of years is the idea that I’m going to enjoy what I’m doing as I’m doing it. Then if, in the future, the world doesn’t go the way that I think, I have already extracted my joy, as opposed to this idea of, “I’m going to work so hard, and in X number of years, I’m going to be happy, or I’m going to be successful, or I will get my payout then.”
That really took a lot of stress off my shoulders, as well as just going, “You know what? The longer I can go having this job and doing the thing that I love doing, the better off I am. The worst case is I don’t get to do this thing I’m excited about forever. The best case is I just enjoy each day, and I keep having those days.” That was a mental shift it took me a long time to get to.
I think a lot of us put our head down and we’re thinking that we’re going to be happy in the future, as opposed to going, “Every year I get to do the job that I want to do the way I want to do it is a huge success, and I should just take that win and go on, and not worry about, am I going to get to do this forever?”

Dr. Tannetje’ Crocker:
Yeah. No, there’s always more, right? There’s always like a next thing or a next step if you’re always thinking that you don’t look at what you have in the moment. I think that I’ve definitely trained my brain a little bit to be like, “What do I have in front of me? It is what it is. What do I enjoy?” I lean into that pretty heavy, and it has served me well as a veterinarian. We’re not talking about discounting at all, but I love this segment.

Dr. Andy Roark:
No. Well, again, I think, like I said at the very beginning, I think discounting is a piece of it.

Dr. Tannetje’ Crocker:
Right.

Dr. Andy Roark:
It really is about, I don’t know, I always love these conversations about what are we trying to build? I think that discounting fits in for some people into the model that they want to build. What do you want to be? I’ve gotten to work with literally hundreds of practices in just the last three years. They’re all different in what they want and where they want to go, and big corporate groups as well. They have different cultures, and they have different aims they want to achieve. I think that that’s really important. I don’t know that people stop and really think about that. I don’t know. I think that whole, “Where are we going? What do we want to be? What is the impact we want to have on the world?”
I think that that’s still a real part of medicine. I think it’s always going to be a part of medicine, because I think that that’s why most of us do the job. Anyway, I love talking about these things because I love to see when people have an intentional direction they lean and say, “This is what I want to be. I want to go right over to this little piece of the world, and I want to-“

Dr. Tannetje’ Crocker:
Make a difference.

Dr. Andy Roark:
Yeah, this little thing. Yeah, exactly. I just think that that’s awesome.

Dr. Tannetje’ Crocker:
It’s fun, because I’m in the social media world, and I think that I still have to tell people all the time, “That’s not my real life. My real life is what I’m doing day to day and what I do in the hospital and what I do with my family.” I share glimpses of that on social media, and I try to share good, and bad, and things that I’ve learned, but it’s amazing how much is not on there, and how much happens in the moment. I hope people get the joy that I have and the things that I’m doing. It’s become a lot more to me about just really speaking to the things that I think are important, and the things I think could make our profession better as a whole, versus gaining followers and gaining likes.
I think that’s also been a good shift for me a little bit. Early on, I was like, “I got to do this, I got to do this, I got to do this.” Real life is so much more important, and you get great connections through social media. I love the networking, and the support, and the community that I built, but real life is still where it’s at. Your day-to-day is still where it’s at.

Dr. Andy Roark:
Well, I think that’s one of the things I always really loved about you, specifically in what you do. I think that there’s danger in social media of it all being performative. I’ve seen that. I started in social media doing in 2008. It’s been great for me. It’s where my career came from and how people got to know me originally. That’s been wonderful. There’s sort of two types of people, I think, that are out doing things in social. There’s the people who are waving their hands and living online, and then there’s the people who are actually impacting the world and talking about it on social.
I think that you’re definitely in the second category, which is, you have thoughts and feelings, and you’re doing the work in the world, which then you can sort of talk about and you give glimpses to. Anyway, I think that there’s a depth to that, that’s really important. I don’t know. That’s why I always love our conversations is that we can talk about communications, and media, and social media, and things like that. At the same time, you’re also working in not one, but two practices that are very different.
You’re clearly working towards an objective. I think that’s really refreshing. I love what you’re doing, Tannetje, and I’m cheering for you.

Dr. Tannetje’ Crocker:
I appreciate that. You don’t think I’m Crocker controversy today?

Dr. Andy Roark:
We’ll wait and see.

Dr. Tannetje’ Crocker:
We’ll see.

Dr. Andy Roark:
We’ll wait and see.

Dr. Tannetje’ Crocker:
You never know.

Dr. Andy Roark:
You never know, but no. Tannetje Crocker, where can people find you online? Tell me about your socials.

Dr. Tannetje’ Crocker:
You can follow me on Instagram, TikTok, or Facebook. Basically just look up Dr. Tannetje Crocker. My name is very distinct, so it’s easy to find.

Dr. Andy Roark:
You can see it in the show notes.

Dr. Tannetje’ Crocker:
You can see it there.

Dr. Andy Roark:
Yeah. I’ll link up to everything on that. Thanks so much for being here. Guys, thanks for tuning in. I hope you have a wonderful day.

Dr. Tannetje’ Crocker:
Thanks for having me. Bye.

Dr. Andy Roark:
That’s it, guys. That’s what I got. I hope you enjoyed it. I hope you got a lot out of it. As always, if you liked it, the best thing, nicest thing you can do is leave me an honest review where you get your podcast, tell your friends, things like that. Anyway, guys, that’s all I got. Take care of yourselves. Be well. Talk to you later. Bye.

Dr. Lance Roasa joins the podcast to talk non-compete clauses! There has been a lot of attention recently on FTC proposed rule makings around non-compete agreements, and some are wondering what’s in the future for veterinarian contracts. Dr. Roasa weighs in on what’s going on and what we can expect in the future.

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

LINKS

Drip.vet: https://drip.vet/

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

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

Dr. Andy Roark Swag: drandyroark.com/shop

All Links: linktr.ee/DrAndyRoark

ABOUT OUR GUEST

Dr. Roasa is a 2008 graduate of Texas A&M who has practiced in small animal, mixed animal and emergency settings and has bought, operated and sold over a dozen veterinary practices. He has completed a law degree from the University of Nebraska, is the past president of the American Veterinary Medical Law Association.

Dr. Roasa is a consultant for VIN and is a founder of Drip Learning Technologies, a veterinary continuing education provider. He also lectures in 13 veterinary colleges on the legal aspects of employment contracts, medical recordkeeping, veterinary malpractice and veterinary business as part of the curriculum. He serves as a national co-advisor to the Veterinary Business Management Association and regularly lectures to regional VBMA chapters and to the national association on the topics of growth, business metrics, and technology implementation.

Dr. Roasa also owns Santa Rosa Ranch, home to the largest registered Brangus cow herd in the United States.

EPISODE TRANSCRIPT

Dr. Andy Roark:
Welcome everybody to the Cone Of Shame Veterinary Podcast. I am your host, Dr. Andy Roark. Guys, I’m here with my friend Dr. Lance Roasa, who is a veterinarian and a lawyer, and he’s been on the episode or been on the podcast many times before. I always love talking about legal stuff with him. I love talking about what’s in contracts that veterinarians are signing and the practices they are using, and we are getting into non-compete agreements today. I’ve got a lot of questions. I feel like there are big seismic changes in non-compete language across the country and across different industries, and there is some FTC proposed rule changes that are shaping up. And I wanted to hear from Lance what those might look like and what he’s seeing in veterinary contracts. And that’s what we get into. So guys, if you got any interest at all in restrictive covenants, non-competes, non-solicitation agreements, non-service agreements, which are a thing we talk about, then this is a great episode for you. I hope you’ll enjoy it. I certainly did. Great, 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 everybody to the Cone Of Shame Veterinary Podcast. I am your host, Dr. Andy Roark. Guys, I am here with my good friend, Dr. Lance Roasa. Lance, thanks for being here.

Dr. Lance Roasa:
Great to be here with you. Dr. Andy Roark. How are you today?

Dr. Andy Roark:
Man, I’m good. Summertime is here in South Carolina. It’s beautiful, but it’s hot. But that’s it for me. How about you?

Dr. Lance Roasa:
Same here. It’s exciting to be in spring. The kids are almost out of school. The teaching semesters, the veterinary schools are winding down, so it’s always a good summer.

Dr. Andy Roark:
So you do a lot of things, for people who don’t know, you do a lot of things like I do a lot of things and I’m like, “That guy does a lot of things.” You are a co-founder at drip.vet. Most people know drip.vet for the opioid education. And so I just recently took your two-hour opioid course. It’s the second time I took it. I took two years before that because I need it for my license every two years. And you had overhauled the whole thing. Nice work by the way. I was like, “I got to watch this thing again.” Nope, it’s all updated, refreshed, super good stuff. It felt very different. So props to you on that. But you also, you are hanging out on the VIN boards, drip.vet is part of the VIN family, and then you lecture all over the place of vet schools. Are you at 20 vet schools now? Something like that.

Dr. Lance Roasa:
Close to 20. Nobody’s really counting, but I think we’re at 18 or 20 vet schools, so I get to see a good percentage of the veterinary students as they enter their third year in veterinary schools. We talk about exciting stuff like the legal use of drugs and how to negotiate their contract and some stuff that I know that they’re just dying to hear about non-competes, which we’re talking about today. So that’s my job in the veterinary schools at this point.

Dr. Andy Roark:
All joking aside, people do get fired up about non-competes. You know what I mean? I am hearing a lot about it. It’s because of stuff going on with the FTC, but also a lot of vets are looking at their contracts. I think non-competes have become part of the battleground in recruiting. There are some big companies out there that have lots and lots of hospitals and they’re saying, “We don’t do non-competes.” And trying to use that as an advantage point in recruiting vets, things like that. I want to unpack this because this is an area where things are changing and people have a lot of interest. And so can you start to lay out for me traditionally what have non-competes kind of look like in veterinarian contracts?

Dr. Lance Roasa:
Sure. So I think to actually take a step back, let’s look at what non-competes kind of look like in society at large. And so in the American judicial system, so non-competes are centuries old. The case law in non-competes go back for literally hundreds of years. I mean even over as we borrowed a lot of our laws from England as we are breaking away as colonies. And so the battleground and the fight over non-competes in a business setting has been something that’s been going on for centuries. And so this is not a new debate, this is not a recent debate. This is the continuation of a long debate. Having said all of that, in veterinary medicine traditionally non-competes have been used sparingly through the sixties and seventies and eighties.
But really when practices starting going corporate, that’s when we really saw an explosion in the use of non-compete agreements. And so now at this point, nearly 99.9% of the practice of the contracts that I see contain a non-compete, especially from a state that will enforce a non-compete. And that brings up a really big point, is traditionally on the law side, non-competes are very, very state dependent, even to the point where they’re county or judge dependent. And we’ve got some states that will fully enforce non-competes and we’ve got some states, California is the biggest example, that will not enforce non-competes. And so you asked about where’s the legal standing, it’s really a state by state analysis to really understand what’s going on with non-competes. And traditionally that’s how it’s been forever.

Dr. Andy Roark:
I was reading recently that other professions have had non-competes kind of struck down. So attorneys and doctors, physicians I saw. And to me it seemed very much like a national thing. And the idea was having a non-compete might force people to break their relationship with their doctor if their doctor had to leave. Same thing with the attorney as you have a relationship with this attorney and then if they have a non-compete, they might be forced to leave, which would not allow you to maintain that relationship. And so the damage to that relationship was something that made sort of regulators say, in this industry these non-competes are not going to be acceptable. Am I getting that right? Is that across industries? Is that still state by state as well? Can you sort of speak to what that looks like?

Dr. Lance Roasa:
Yeah, you’re actually really close with that. It’s not necessarily-

Dr. Andy Roark:
Oh, good. I like to be at least in the neighborhood. That’s good.

Dr. Lance Roasa:
You’re definitely in the neighborhood. So on the legal side, it’s actually the legal ethics or what they call the professional responsibility will not allow attorneys to put other attorneys under a non-compete. And so it’s highly ironic that attorneys are asked to write non-competes for other professions, but they will not write a non-compete for their own profession. And the basis for that is exactly what you described, is it’s not a competition issue, it’s not a free market issue. It is the fact that the consumer of legal services in this case, their relationship would be highly damaged. And so if a lawyer leaves a law firm, then they’re welcome to take all the people that they served previously. On the physician side, what you’re referring to is some guidance that’s coming out from the AMA, the American Medical Association that says roughly the same thing. That physicians should not put other physicians under a non-compete for patient safety, for patient continuity, for the fact that that patients need to see a doctor continuously, not just the person that’s working at the hospital that day.

Dr. Andy Roark:
Yeah, that makes sense.

Dr. Lance Roasa:
Now, having said all of that, physicians and nurses and other healthcare providers are probably some of the people that are most affected by non-competes. So just because the AMA said, it does not mean that non-competes are somehow banned or not allowed in the human medical world.

Dr. Andy Roark:
Well, it’s interesting that you said doctors will not put other doctors under this. And I’m looking at the human medical world and I go, “Boy, there’s a lot of big corporations that own hospitals or medical groups or things like that.” Do they fall into that same category or is it something where you say, “Well no, these are not physicians putting other physicians, this is a different entity that’s getting physicians to sign a non-compete.” Is that different?

Dr. Lance Roasa:
It’s back to the corporatization world. And so it’s the fact that those hospitals that are truly employing those physicians are really corporations, honestly. So it looks a lot like if the AMA decided to put forth ethical guidance that said that veterinarians will not put veterinarians under non-competes. Well, a lot of hospitals are not owned by veterinarians. And so the AMA has no control over the corporate interests in our profession.

Dr. Andy Roark:
Interesting. Okay, all right. Lance, let’s start to talk about trends in the vet profession with non-competes. So I think back when I graduated about 15 years ago, non-competes were pretty standard and we were sort of instructed to pay attention to them. To pay attention to how much distance there was, how much time they would go for after you left your job, things like that. Have you seen a change or a trend in shrinking sizes, things like that? Or is it basically the same durations and distances that used to be, but they’re either in or out. So can you talk about general trends in that regard?

Dr. Lance Roasa:
Yeah, so there is a general trend on the legal side. So lawyers that write non-competes, to write them in the exact words are narrowly tailored. So to make them exactly what the protection of the business or practice in this situation needs. And so if you see a non-compete that is written by a lawyer that’s kind of studied on non-competes, they will try to write them in a very tailored way. And the reason for that is because they actually become more enforceable the smaller they are. Now you asked about timeframe, the timeframes still are almost always maxed out as what the law will allow. So some states, Florida, for example, 18 months, other states will presume that two years is reasonable. And so almost every practice and every lawyer that’s putting forth a non-compete is going to max out what the law will allow. The radius is very, very, very dependent on the practice locality, the practice type, et cetera.
The other thing that I really spend a lot of time teaching on, Andy, is what’s called the scope of practice. And so there’s three things to really look for. You’ve already mentioned the timeframe and the radius, but the third thing that is highly negotiable is the scope of practice. And so when you and I both graduated, there were a lot of mixed animal practices and there was an expectation that we would kind of do everything. But now practices are much more specialized. And so there’s day practices, they’re ER practices, there’s exotic practices, there’s small ruminate practices, there’s obviously equine practices. And so these non-competes that exempt all of practice, that’s a problem. And so what you see is practices start to say, “We’re only going to exempt daytime non-emergency practice.” Or, “Since we’re an ER practice, we’re only going to exempt competition in an overnight ER practice.”
And so the tighter that you can get that scope of practice allows that veterinarian to go on and do something else. But to answer your question, yes, these are constantly evolving. The other big thing that I see, that’s the difference when we graduated 15 years ago, is this use of the liquidated damages. And I think we’ve talked about this on a previous cone of shame podcast, but highly aggressive attorneys will write liquidated damages, which means that the damages are stipulated before you actually even breach the non-compete. And that’s a massive shift from what was in place 10 or 15 years ago. Non-competes are becoming more aggressive, but in certain situations they’re actually becoming more and more narrowly tailored.

Dr. Andy Roark:
If you dream of doing team training with your team, getting your people together, getting them on the same page, talking about how you guys work together in your practice, I’d love to help you. You can check out drandyroark.com and check out the store. I have two different team training courses. These are courses for teams to do together to get on the same page and to talk about how you do things. I have my angry clients course and I have my exam room toolkit course, and they are both available and there to come out. All right, guys, let’s get back into this episode. Well talk to me a little bit more about this calculating damages. So the stipulation that you’re calculating damages before the breach of the non-compete occurred, what does that mean, Lance? Help me get my head around that.

Dr. Lance Roasa:
Yeah. So usually there’s a provision that’s attached to the non-compete provision, which says something like, “If you breach the non-compete, the associate, the employee, or now former employee, will pay the practice.” And usually it’s a large sum of money, Andy.

Dr. Andy Roark:
Just a flat fee?

Dr. Lance Roasa:
Just a flat fee, a hundred thousand, $150,000 to breach the non-compete. And usually when a veterinarian sees that, they’re like, “Now wait a minute, I have to pay the practice money. I’m getting paid by the practice. I’ve got to pay the practice money back. So where’s this $150,000 coming from?” They’ll kind of throw a red flag and say, “Ah, this doesn’t feel right. $150,000 doesn’t seem right.” What smart lawyers have learned to do is write a per diem amount in lieu of a breach. And so they’ll say something like, “If you breach the non-compete, we’ll stipulate damages of a thousand dollars a day.” Well, if you breach the non-compete for 150 days, you’re at the same exact point, you’ve got to pay the practice $150,000. But to the veterinarian that’s skimming that contract and not really understanding the legal terms, they’re like, “Oh, a thousand dollars, whatever.” That doesn’t really draw the red flag like $150,000 line item in that contract. So it’s a way to sneak these liquidated damages provisions past associate veterinarians and get that signature.

Dr. Andy Roark:
All right. So that makes sense. I was actually surprised when you said early on that 90% of the contracts that you see still have non-competes in them.

Dr. Lance Roasa:
I would say 99.

Dr. Andy Roark:
Really?

Dr. Lance Roasa:
Yeah, no [inaudible 00:15:01].

Dr. Andy Roark:
I felt like I felt like we were moving away from that. I was hearing more and more people saying, “Oh yeah, we’re not doing those anymore.” But you’re not seeing that on the ground. Is that correct?

Dr. Lance Roasa:
No, there’s a couple of large practices that have moved away from non-competes, but overall the vast majority of practices still use non-competes. There’s a couple of commentators that have written and talked about abolishing non-competes or getting the profession away from non-competes, but I have to be honest, that’s just talk. I mean, in the real world, I’m not seeing it change at all.

Dr. Andy Roark:
No, that totally makes sense. Talk to me about what’s going on at the national level. So there was sort of FTC proposed rule makings that were sort of in the headlines recently and people were talking about some of the Biden administration’s thoughts on non-competes and stuff. Talk to me about sort of what’s going on there.

Dr. Lance Roasa:
It was a pretty boring read overall, but what it does is it attempted to make the case that the FTC does have the ability to regulate non-competes across the entire country. And basically it said that the FTC is thinking about banning non-competes on a federal level. Now the thing that I really want to point out here is, is this is an extremely slow process when we’re going through what’s called the Administrative Procedures Act. What the FTC did is they opened a notice in comment period, and they allowed the American people and business interests to come and weigh in. The FTC will gather all those comments, read them all, and then ultimately deliberate internally on whether or not they want to proceed with some sort of actual rulemaking. And so generally speaking, this stuff takes years, if not decades to fully come to fruition.
And really what I saw when the Biden administration first issued, “Hey, FTC, do something about this.” And then in January of 23 when the FTC actually released this notice or this proposed rulemaking, I got a lot of comments just right off the bat. And actually a lot of anecdotal comments like, “Hey, these non-competes, they’re going to go away and I don’t have to worry about this anymore.” And I’m like, “Whoa, whoa, whoa, pump the brakes. This is really a time to hold your horses. Do not sign a non-compete with the expectation that the FTC is going to do something to nullify it. You’ve got to still negotiate it. You’ve still got to understand what it’s going to affect, how it’s going to affect your personal life if they don’t do something about it.” So it’s good that the FTC is giving this a look. It’s good that it’s getting some light shined on it, but it doesn’t mean that we can ignore non-competes any time for the foreseeable future.

Dr. Andy Roark:
Yeah. What do you think the future’s going to be like in non-competes? When I go sign a vet contract five years from now, do you think it’s going to look different as far as non-competes go? If you had to bet, what would your bet be?

Dr. Lance Roasa:
So we’re seeing a push across many states to actually change. And so I think that the state level has much more potential to actually change the enforceability of non-competes overall. Ultimately too, Andy, it depends a lot on the market for veterinary services. And so you mentioned earlier you’re seeing some people start to talk about it and a few companies start to say, “We’re not using non-competes.” If it truly does work out to be a recruiting tool and hasn’t necessarily so far, but if it truly does work out to be a recruiting tool, then you’ll see other companies follow suit. And so it depends on the state that you’re in. It depends on the company that you’re looking at overall. But I see non-competes sticking around for a little bit longer.
There’s a really big point that I want to make here when you’re looking at that contract though, and pardon my football analogy here, but my brain often thinks in football terms. But non-competes in my mind, in my legal mind, are really the running backs of the football team. They’re the ones that get their picture in the paper. They’re the ones that everybody talks about. They’re the ones that little kids remember the stats and all that stuff. But in reality, when it comes to lawsuits and when it comes to actually enforcing a contract, it’s the non-solicitation that really counts. And so I do want to point out that the states and the FTC and even these companies that we’re referring to, they’re talking exclusively about non-competes and doing away with non-competes.
However, no one, including the state of California, is talking about doing away with non-solicitation agreements. And so even if we do have some guidance or some rulemaking by the FTC within five years, Andy, that contract that you’re looking at in the future will likely have a non-solicitation. And that non-solicitation still is very prohibitive from being able to go and practice somewhere else. In fact, it can be argued that it’s more prohibitive because it doesn’t have a radius on it. Wherever those clients follow you, you can run into some issues. So what I’m saying is this is not an area of the law that’s going to go away anytime soon.

Dr. Andy Roark:
So my perception of non-solicitation agreements had always been like, “Okay, you can’t market or promote to clients.” If I’m leaving and I go somewhere else across town, what constitutes solicitation in most cases, Lance? Like if I just go there and start practicing, am I good? Or is it a problem if clients follow me over there? Help me sort of parse that.

Dr. Lance Roasa:
Yeah, there actually is a big distinction in what you’re referring to there. So the distinction that we’ve got to make is the difference in a non-solicitation provision and what the second would be a non-service or a non care provision. So two different action verbs, but a lot of times they get wrapped under the provision that is a non-solicitation. Now if you look back 10 or 15 years, they were all non-solicitation provisions, but as lawyers in veterinary medicine got more sophisticated, they started drafting these non-service provisions. And so back to the distinction between the two, the verb solicit or to solicit would mean exactly what you said, a targeted marketing, a targeted advertising. And keep in mind on the word targeted.
And so if the traditional word is, or the traditional action would be you’re going to pick up the phone and call someone, or maybe you run into an old client in the grocery store and you say, “I was at practice ABC, now I’m at practice XYZ. You should come see me there.” That is an active solicitation. Sending out a list to an email list to people that you knew that were clients. “Hey, come see me at practice XYZ.” That is a targeted marketing, and that is contrasted to if the contract has a non-service provision in it. And the way that those are usually worded is they’ll say something like, “The veterinarian shall not solicit or render services to a former client.” And so meaning that under a technical reading and also an enforceable reading of that, you could be standing in the exam room waiting for your 3:30 appointment, 3:30 appointment comes into the exam room, “Oh, Ms. Jones, I saw you over at a ABC Veterinary Hospital.”
That would be a technical violation of that non-solicitation/non-service provision. So I’m seeing more and more of these non-service provisions written in contracts, and it really takes a fine reading to understand the difference. But I think you can see how quickly a veterinarian could get wrapped up into a non-service provision. So my mind always goes to how do we combat this? How do we negotiate this? Well, number one, know the difference between the two and number two really work to get that non-service provision stricken out of the contract. Keep in mind, Andy, all of these are super negotiable. You just have to know what you’re looking for and how to ask for it taken out.

Dr. Andy Roark:
Yeah, no, that totally makes sense. Usually when you’re close to signing a contract and you’re excited to go there and the practice is excited to have you, that’s the time to bring up the non-compete and say, “Hey, this is kind of a headache here.” But it’s a whole lot harder to get out of it later on.

Dr. Lance Roasa:
Oh, absolutely. The time to negotiate these are before you get into them. I mean, this is a very important point. A lot of people that I work with, they say, “Hey, can you unwind this non-compete? I heard they’re unenforceable.” And it’s like, “No, we should have talked about this, you should have talked about this before we signed this.” That is the time that you have the leverage when you’re leaving a job. It’s like breaking up. I mean, it’s like a divorce, right? Nobody wants to be amicable during a divorce and it’s really hard to negotiate them then.

Dr. Andy Roark:
Yeah, no, that totally makes sense. Lance, thanks so much for being here. Thanks for talking all this through with me. I really appreciate it. I was blown away. The non-service agreement, I had not even considered that. That’s something that I think it’s amazing. I can’t believe that that’s something that’s increasing in its commonality. Anyway, so thanks for bringing it up. Where can people find you, drip.vet, if they’re fascinated by the legal aspects of our profession, if they need a little legal advice and they’re in practice, where can they reach you?

Dr. Lance Roasa:
Sure. So I hang out over on the VIN boards, on the regulatory and legal boards, and also on the practice management boards. I’m one of the consultants on those boards. And so if you’re a VIN member already, you can receive… we can talk about these things and obviously weigh in from other attorneys, and we answer a lot of questions over on those boards. Otherwise, I’m also at drip.vet, and so have a ton of legal continued education over there, classes on negotiation, on contracts. We go into deep dives on all of this stuff. And then if you are truly interested in it, and unfortunately, most of the people that I work with have already been burned by a non-compete. So it’s not too interesting as a student, it’s not too interesting in your first job, but you get burned by that paragraph and then it’s time to start paying attention.

Dr. Andy Roark:
Absolutely, awesome. Well, thanks for being here. Guys, thanks for tuning in. Thanks for listening. We’ll talk to you soon. And that is our episode. Guys, I hope you enjoyed it. I hope you got something out of it. As always, if you did, the kindest thing you can do is leave me an honest review online, wherever you get your podcast. Tell your friends, share the word, help other people find the podcast work that we’re doing here. Anyway, that’s all I got. Gang, take care of yourselves. Be well. Talk to you later. Bye.