Dr. Ivan “Zak” Zakharenkov joins the show to talk about a recent article of his, and the wellness research he is doing in the veterinary industry. He and Dr. Andy Roark discuss the impacts of production-based compensation on wellness and well-being, and how veterinary teams might be compensated in a more satisfying way.
You can also listen to this episode on Apple Podcasts, Google Podcasts, Amazon Music, Soundcloud, YouTube or wherever you get your podcasts!
LINKS
Article: Does Production Pay Undermine Veterinary Team Well-Being?
Galaxy Vets: An Employee-Owned Veterinary Group
Book: Great Game of Business
(Links to Amazon.com are affiliate links and help support the show)
Dr. Andy Roark Exam Room Communication Tool Box Team Training Course
Dr. Andy Roark Charming the Angry Client Team Training Course
ABOUT OUR GUEST
Dr. Ivan “Zak” Zakharenkov is a veterinarian, entrepreneur, and advocate for the well-being of veterinary professionals. After graduating from the Atlantic Veterinary College, he worked in various settings across Canada, from emergency to general practice. Twelve years in veterinary medicine inspired Ivan to create Smart Flow, a workflow optimization system, and Veterinary Integration Solutions, a consultancy serving veterinary consolidators. In 2021, he founded Galaxy Vets, an employee-owned veterinary healthcare system that prioritizes burnout prevention. He holds an MBA degree from the University of Cumbria in international healthcare management. Ivan serves on the board of Galaxy Vets Foundation and co-hosts Veterinary Innovation Podcast and Consolidate That!
EPISODE TRANSCRIPT
Dr. Andy Roark:
Welcome everybody to The Cone of Shame Veterinary Podcast. I’m your host, Dr. Andy Roark. Guys, I’m here with the one and only Dr. Ivan Zak. Ivan is the CEO of Galaxy Vets, and he does a lot of things. He wears a lot of hats. He’s a practicing emergency vet. He’s a genuinely, deeply interesting guy. This is a sprawling conversation about, it starts off talking about compensation and production-based compensation and the impacts it has on wellness in vet medicine. And then we get into lots of different aspects of how vet medicine works and what are some of the underlying issues that we see with burnout, and is vet medicine really worse about burnout than other industries? And it all goes from there.
And so anyway, it is a really good, fun discussion. A lot to think about. I thoroughly enjoyed having Ivan on the podcast. Gang, I hope you’re going to enjoy this. Let’s get into it.
Kelsey Beth Carpenter:
(singing) This is your show. We’re glad you’re here. We want to help you in your veterinary career. Welcome to The Cone of Shame with Dr. Andy Roark.
Dr. Andy Roark:
Welcome to the podcast, Dr. Ivan Zak, thanks for being here.
Dr. Ivan Zak:
Hey, and nice to be here. Thanks for having me.
Dr. Andy Roark:
Man, I am so psyched that you’re here. First of all, I thoroughly enjoy talking with you. You are just an interesting guy. You’re doing a ton of stuff. For those who do not know you, you are the CEO of Galaxy Vets. You were the creator of Smart Flow. You are a co-host of the Veterinary Innovation Podcast. You’re practicing, you do some emergency work, you’re still in practice. You got your hands in it. You’re just a genuinely interesting guy doing a lot of stuff. And so I was really happy to have you on because I saw something that you wrote on VIN. It was on the VIN News Service. And first of all, just stop and shout out to the VIN News Service. I love that team. They just do do great work, and they just put out really interesting stuff. So if you’re not reading VIN News, you’re missing out.
But anyway, you wrote an article called, Does Production Pay Undermine Veterinary Team Wellbeing? And this was something that I saw it immediately, it spoke to me. I think this is fascinating. So we talk a lot about compensation of veterinarians on this podcast and how the business of vet medicine happens. And so production based compensation is really common in our industry. And I actually just got an email from a veterinarian who’s not paid on ProSal or production based compensation, and they were like, “I feel like I should be. Do you agree?” And I thought, oh man, production-based compensation has become fairly ubiquitous in our industry. And I’ve always had some questions about it.
And let me be open and say I get paid on production when I work in the practice and I don’t seem to have problems with it, things like that. But I’ve always been a little wary of being like, yeah, paying doctors on production is the answer. It does not have drawbacks. It’s the way we should go. And so I saw your article and it really spoke to me. Let me just pause here for a second and say why, if you don’t mind, lay out your philosophy here as you start talking about production-based compensation as it interacts with team wellbeing.
Dr. Ivan Zak:
Yeah, so the topic is fairly early long standing with me too, because as a practicing veterinarian, I actually worked only my first year out of vet school on production because I saw the numbers. They said You could be on salary, you could be on production. And then they showed me numbers in three months and you would be an idiot not to start on production. I was making better money. And then the first year out, I think I was making more than anybody in my class. I jumped right into emerge. So that was good. But then because you’re an emergency and because I realized that when people are yelling in your face that you’re doing it only for money, then that was my, I was like, what if I was not, and I can prove it?
And then since then, after the first year, never worked on production. So I had my own thinking about it and it’s just an opinion. And you put three vets in the room, you’ll get four opinions as usual. So we tried to test that. I wanted to see actually statistically can we survey? And the third year in a row we’re doing this study where we are measuring the burnout and what we do in parallel with that, we give it a color and we say, okay, well what does burnout correlate? So one thing we do, we measure how burnout the industry is based on a sample size, usually about 2000 people.
And then with it, we had certain hypotheses that we throw in every year into a study. For example, what does compensation method do to burnout? What does the age do? What does the experience? What is the gender? And things that we want to know to better understand who’s the biggest risk, and then how can we manage hospitals, people, and everything to have less burnout? So that was the intent with which we studied it, and I wanted to prove myself right or wrong in my own hypothesis that production’s evil. So that was how we started.
Dr. Andy Roark:
Okay. You were a bit more to the point that I was, but yeah. All right. So the null hypothesis is production is evil. All right. Talk to me a little bit about, before we get into this, talk to me a little bit more about the burnout study. I have been watching this for years. I read it whenever it comes out. I’ve not talked to you about it in the past, but I have always watched it and I’ve always appreciated that you do it. It seems like good work. You do get a pretty good sample size. It’s across different roles in the vet profession, things like that. Talk to me about where your interest in burnout came from and just start to tell me the story of the previous years leading up to this one, if you don’t mind.
Dr. Ivan Zak:
So I got exposed to it through my personal experience and I’m fairly comfortable talking about it right now. But I personally almost lost my life through a suicide attempt. And essentially I didn’t know that. Now I know about myself back then and then I just thought, I hate my life now. I understand that more than myself. People hate life and a lot of them are veterinarians. And I’m comfortable because I think that we should talk about these things, especially if we get through it and then we are trying to analyze it.
So when I pivoted in my career career, we built Smart Flow, I love our profession. And at the time when it happened, I hated it. So then when I had a choice in what am I going to do next? And I was going through MBA and I chose as my thesis for the dissertation to research burnout, I wanted to find out is it systematic? Is it actually a problem in the industry? And if it is there a solution for it? And I wasn’t looking for a solution in medical or mental or anything like that. I was thinking that there’s probably a management problem to it. I think we’re driving people insane and then is there something that we can do better by managing people and prevent burnout through that? You should do yoga, you should meditate, you should work in flow that we talked about before recording. All of those things, but can we manage people better?
So I made it my career choice now in the next hopefully five, 10 years to focus on understanding how can we manage organizations better to prevent burnout. And that’s why this study became the research portion of my dissertation. And I’ve been repeating it since then. This is the third year that we came up with it.
Dr. Andy Roark:
Yeah. First of all, I love that and I think you’re spot on when I talk about burnout and preventing burnout, to me, I don’t like when I hear this idea that self-care is the answer to burnout. Because what you’re doing then is you’re acting like the person, the individual on the floor in the clinic, they have the power to take care of themselves and there’s no obligation of the practice that they’re in to not burn their people out. And I go, look, let’s be honest, it’s a division of labor here. It’s one, I have responsibility to take care of myself and to rest and recharge, and my practice has a responsibility to not throw me to the wolves every day and push and not let me take breaks or make me feel bad for taking breaks and things like that. I think about in two levels there’s the individual level and there’s a practice level when we start talking about this.
So listen, I’ve always enjoyed that you do this. I also, I a hundred percent with you on telling the stories of burnout and depression and things like that is just, I went through a period of burnout. It’s been about four years ago and I burned out pretty bad. And the thing that bothered me the most at the time was that I didn’t know anyone who had really burned out and then come back and seemed to be having a good time later on. And it felt like the end for me. And so I’m like, I did it. I would not recommend it. If you’re like, “I’m thinking about burning out,” I’d be like, “You should do yoga instead. Go on vacate, do something else, pick something different.” But if you do decide to burn out, just know that you can work through it. And honestly, you can have the best days ever on the other side.
So anyway, I love that you did that. Let’s start to talk about your findings on compensation in wellbeing. So will you break that down for me?
Dr. Ivan Zak:
Yeah. So the hypothesis, every research, our first research that we’ve done for my actual dissertation was we wanted just to measure it and then understand, is it because I thought maybe it’s like a shark attack, someone is killed by a shark and everybody’s like, “Oh my god.” But no truly we’re burnout. We determined in the first year, but then in parallel we just ask random questions like, what’s your age? What’s your gender? Do you work in corporate setting? I thought that corporate is evil, so therefore they probably burn out people more. Turned out that they’re actually not true, which-
Dr. Andy Roark:
Okay, I believe that. Yeah.
Dr. Ivan Zak:
Yeah. So that was proven wrong. So then we thought, oh cool. So we have a standard measurement of burnout. There’s a standard thing that we use, it’s called professional fulfillment. And this is just 16 questions, but it gives you this temperature gauge. And then in parallel we’ll throw in questions that we’ll read the stats and say, okay, people that are over 40, they’re less burned out than those that are under 40. And then women are more burnout than men. So there’s things that we started to look for last year. I was interested is goal setting in your career and life affecting your burnout status, which it does if you don’t have goal setting.
And this year I was wondering, okay, the evil production that I thought it was, is it actually evil in terms of burnout? Does it contribute to burnout? And that was one of the three things that we tested this year. And we’ve proven myself almost wrong. So essentially it was the reverse, which was shocking to me because there’s multiple studies in human health where it clearly says that production actually does cause burnout. So that’s an interesting finding.
Dr. Andy Roark:
All right, so talk to me about this. So what you’re saying is in the studies that you’re doing, you found that production was anti burnout related. Do you feel like being salaried is more likely to lead to a path to burnout? Tell me about that.
Dr. Ivan Zak:
So not necessarily in that direct correlation. It wasn’t like, oh, stop being on salary and you’re fine. You can’t apply it as a treatment. But the point is that what we found out, people that have less financial security and certainty in the future are more burned-out, which logical, but we wanted statistically to prove that. But then the second comparison of data showed that people that are on commission feel like they have better financial security. So it was not a direct, but it was an inference through this people that are on commission or production, they feel like they’re more secure in their financial future or retirement planning. And it turned out that those people are less burned out. So it didn’t show that it directly causes the burnout, which I was surprised. It could have proven my 20-year hypothesis being wrong. But that’s why you do the research to prove yourself wrong.
Dr. Andy Roark:
No, that makes sense to me.
Hey guys, I just want to let you know real quick, I got something really big coming down the pipes that is super fun. It’s not a workshop, it’s not a webinar, it’s not a live event, it’s not a summit, it’s not a program. It is something that is just going to be a ton of fun. And some of you have already found the path to learn more about it. I’m not going to tell you what it is here, I’m just going to tell you it’s great and it’s coming. And if you want to look around a little bit, you might be able to find the path to learn more. And so some of you already have, some of you have not.
If you’re like, “I don’t know what he’s talking about.” [inaudible 00:12:53] don’t know if you like puzzles, if you like trivia, trying to figure things out, find the root of questions. It might be worth poking around DrandyRoark.com. Definitely the newsletters, if you get the newsletters, there’s fun stuff there. But if you like figuring things out, it might be time just to poke around a little bit. We got some fun stuff going on. That’s all I’m going to say. I’m just going to leave you with that, guys. As you were. Enjoy the rest of the podcast. I’ll have some more news for you sometime soon.
So I like [inaudible 00:13:26]. Do you think the idea basically is that if you’re paid on production, then you feel like you have more control of your situation as you summarize it that way?
Dr. Ivan Zak:
I think that’s one of those things. But if I correlate it to burnout, because burnout has a lot of people only talk about burnout. They really imagine it’s like working too much. I work in a facility right now, I do a couple shifts a week in ER for fun. And I have clear understanding that people are burned out in it, but they don’t have a full workload. This hospital is not loaded enough with the patients, it’s a new startup, and they have all other things that organizations can do wrong to actually cause the burnout, such as there’s lack of control, they feel like they’re top-down managed, there’s complete disconnects of values. So that’s the second one.
These are defined in 1986 by Christina Maslach who researched burnout in organizational behavior. So these are the actual triggers. So lack of control, conflict of values, insufficient reward not only in monetary because they actually compensated well, but not enough thank you and just basic gratitude, unfairness, favoritism people on the same sort of level getting different pay rate with no explanation. And community breakdown, which means that we don’t know how to give feedback to each other and we don’t know how to resolve conflict, which is systemic.
So it’s not about working too much, it’s about other things that can happen with it. So I think that when we talk about people on compensation or not compensation, I think we need to look at the big picture of how people are working. Because let’s say I’m on production and it seems like I’ll have less burnout, but what I’m doing, I’m driving the entire team crazy and I’m just go, go, go, go, go because I am chasing the dollar. I want to be a productive, but what techs get per hour while I’m burning them out? And they’re actually more burned-out than vets usually. So I’m actually creating the environment in which techs assistants and receptionists are running crazy without compensating more. So the question of compensation of the organization is bigger than just one individual as a vet, but how do you compensate the team and align the incentives so everybody’s rowing in the same direction?
Dr. Andy Roark:
Is it possible to see that? Is it possible to look at the support staff who work with doctors paid on compensation versus support staff who work with salary doctors?
Dr. Ivan Zak:
So we are trying this, so we just launched it two months, actually two quarters ago, and we launched this and it’s very interesting. So there’s a book called Great Game of Business. It’s the whole methodology. And what they recommend is creating this bonus structure in which essentially what vets don’t do as business people, they don’t set the budget. That’s just, corporations do that. Individual vets, they never say, “This is my budget.” Because when we hear budget, we always think that budget is how much I can spend. This is not in the budget. You can’t buy an extra chair, you can’t buy another anesthetic monitor or whatever. But also budget is how much I’m planning to earn.
So what we’ve done in our bonus design, we said, okay, our plan and we reporting to investors is to be in this budget, you need to hit this number in June, this number is July, this number in August. If we all as a team hit the number above that, anything in surplus will be split between the teams as a bonus. The bonus is not in January, here is Christmas bonus for no reason. It’s not a gift. The reward with a very clearly articulated goal.
So essentially I think, and this is my new hypothesis, is that this way if the doctors on the production driving the team and driving everybody, but then the team knows is if they help this doctor to produce and they hit it above the budget that we clearly identified for them, we show it actually in the app. We have an app that all our employees have. They know how much they make per day in the clinic. It’s open book management and they’re trying to hit it above the waterline that we set. And if they do in the end of the quarter, each quarter they get a little check that represents the bonus.
Dr. Andy Roark:
Yeah, I like it. I always like it. So I’m a big fan of positive reinforcement and like you said, giving positive reinforcement when it’s a clear link to the behavior that we’re reinforcing and you’re like, this is what it is and this is what you did and this is when you’re successful and here’s how we’re being rewarded. That’s always spoken to me. Talk to me a little bit more about we have a problem with feedback and conflict resolution. You said that’s systemic. What do you mean when you say that?
Dr. Ivan Zak:
Well, we had a really interesting conversation today in our podcast about in general how we communicate in veterinary domain. So I can’t quote the study and I know that it floated through my desk one day, but apparently vet industry is the lowest EQ that you can find profession. People that want to work with animals and not talk to people, everybody says that. And then we’re just not trained through either we’re in tech school, whether we’re trained for animal attendant or veterinarian, there’s very little on how to talk to each other. There’s how to talk to clients. There’s how to articulate diagnosis in more simple terms. Now it’s there in schools, there’s never, how do you become a leader? How do you become a communicator? How do you provide and take, which is very important feedback, and then how do you resolve the conflict?
So I think that those are the huge, huge deficiencies. And whenever we go into a new team, so when we acquire practice, we go in and we understand, do people know that? And it’s just a baseline. It’s the basic training where you type people. I hate saying it like that, where you’re typing people, but you do the disc, you understand what they are so you can communicate with each other and understand that person like me would never talk to someone analytical and solve something on the spot. They’ll need a day to think about it. And then also, how do you resolve things? How do you don’t become passive-aggressive? All of these things, I think we just don’t have it. It’s just not in the curriculum wherever we come from. And I think it is pretty chronic in the industry.
Dr. Andy Roark:
That does make some sense. If you had your magic wand, and so you’re looking at this and you’re looking at the data, not just this year’s wellness study, but previous year’s wellness studies and we’re talking about feedback and we’re talking about resolving conflict and things. How do you fix this profession in the next five years? You got magic wand power, you could make some changes. What would you do?
Dr. Ivan Zak:
Yeah, that’s a good question. That’s a million dollar multimillion dollar question.
Dr. Andy Roark:
Oh, sure.
Dr. Ivan Zak:
I think if you let people solve their problems and the place where they work themselves, that’s the main thing. Stop being a manager who decides for the people that do the job how to do their job. If you can just give them the autonomy to decide that I have a problem X, but you need to give them power and say you are responsible and accountable. And then that leads to the compensation through the proper compensation structure that by fixing these problems and becoming more productive and efficient, you’re rewarded at the end as the business owner or just someone who receives bonuses is there as well. I think if we can allow all of our people, techs, vets solve things and the management would just support and create a system of idea generation and putting them into practice, I think that would be the best way.
Dr. Andy Roark:
I have this theory that veterinary medicine, I don’t have a survey to back it up, but I have this theory that veterinary medicine, I think we’re disproportionately perfectionistic. I think that there is a perfectionistic tendency in veterinary medicine. I think there’s a lot of people who want to get things right. I think we select for that tendency in veterinary schools and our education and things like that. And my thesis goes, if you buy into the idea that veterinary medicine as a whole is more perfectionist than other industries, I think that this is the number one reason that we struggle to delegate effectively is because there’s a right way to do it, and we know what the answer is, and we want to give the answer.
And in order to delegate effectively and empower people, just like you’re saying, Ivan, I’m a huge believer in this, take people the problem and let them come up with their own solution. But I feel like people struggle so much to do that because they want to say, “This is the answer, now do the answer.” And that just, it’s hard to get traction. Do you buy into any of that? Do you buy into the perfectionistic part? Do you think that that’s a barrier to letting people be empowered to fix problems on their own?
Dr. Ivan Zak:
A hundred percent. And I think that this is a huge part of our burnout problem because it’s almost like we’re in the veterinary podcast, so it’s almost like we’re breeding and selecting the breed with a certain traits for intelligence, solution orientation, everything else. But in parallel, we get this perfection. And perfectionism actually is not a good thing. People that are proud and saying, “I’m perfectionist,” it’s a form of fear. You’re afraid to make a mistake. So if you look at it from that angle and thinking that you’re proud of being perfectionist, that’s not a good thing. That means that you’re afraid to make a mistake and try something new. So I think that you’re absolutely right. We’re selecting people with a certain traits and it drags behind it, the burnout, people that are more susceptible to it and all other things.
Dr. Andy Roark:
No, I love that you say that way. It’s funny, the paradox that I put together is our selection criteria is very much pro perfectionism, right? Because you take that test by yourself, there is no delegating. It is you, yourself, self-improvement is painful because you’re both the hammer and the chisel or you’re both to stone in the chisel. And it’s sort of the same thing as people who excel in the academic part and get into vet school and do well in vet school are often that driven perfectionistic personality. But then if you want to become a high performing veterinarian, you want to build a really good, positive workplace, that’s antithetical to that mentality. It has to be the doctors that really perform there are a little bit more loosey goosey.
They’re a little more willing to let other people do things and say, “The team is excited about this. It’s not exactly what I would do, but I think it’s positive. I think my idea is better, but it’s not the one they’re excited about. So I’m just going to go along and be supportive of them.” I think that that’s one of the weird pain points that we have is what gets you a degree is not necessarily what’s going to make you happy and maximally successful afterwards.
Anyway, Ivan, thanks so much for being here. Thanks so much for talking with me. You’ve got a lot of irons in the fire. Do you want to talk real quickly about where people can find you? Where can they learn more about Galaxy Vets? Where can they hear the Veterinary Innovation Podcast? Tell me about all you got going on where people can keep up with you.
Dr. Ivan Zak:
Yeah, well, thanks for inviting me first, and then that was a great conversation.I do recommend, suggest subscribing to Veteran Innovation podcast, which you can find@veteraninnovationpodcast.com. There’s a great conversation always about innovation, so sign up for that. That’s a cool one as well. And then Galaxy Vets is just the project we’re trying to implement all of these anti burnout practices and management. So all the research that we do, it’s incorporated into building this organization that is owned by veterinarians and employee ownership is incorporated into it. And that one is at galaxyvets.com. So either one, you can find us there or on LinkedIn if you can spell my full last name, but I’m not going to do it here.
Dr. Andy Roark:
I’ll put links in the show notes to all that stuff. Guys, I’m going to link to the Great Game of Business, the book that Ivan mentioned earlier. So I’ll put a link to that in the show notes. Guys, thanks so much for being here. Thanks for listening. Take care of yourselves, everybody. I’ll see you later.
Dr. Ivan Zak:
Thanks, Andy.
Dr. Andy Roark:
And that’s what I got for you guys. I hope you enjoyed it. Thanks, doctor Ivan Zak for being here. Man, he was great. I’m going to have him back on the podcast. I just really enjoyed this conversation. I think I’d like to talk to him more often. So anyway, I thought it’s super fun. I love these idea type conversations. I hope you guys enjoyed them as well. If you did, do me a favor and write me an honest review wherever you get your podcast, share the podcast with your friends. That’s really nice thing that you can do. Anyway, guys, take care of yourselves. Be well. Talk to you later. Bye.