Team Culture

Dr. Matt Salois joins the podcast to discuss the currently perfect conditions for an influx of new independent practice owners. In this episode of the Cone of Shame Podcast, he and Dr. Andy Roark explore how the slowdown in corporate consolidation combined with the availability of technology and services could spark a renaissance in veterinary practice ownership. They also touch on the future of independent practice ownership and the changing demographics within the field. Tune in to understand the evolving landscape and what it means for aspiring veterinary practice owners.

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

LINKS

Matt Salois LinkedIn: https://www.linkedin.com/in/msalois/

VMG: https://www.myvmg.com/

Team Training Kit: https://drandyroark.com/product/team-training-bundle/

Charming the Angry Client Course: https://drandyroark.com/charming-the-angry-client/

Dr. Andy Roark Swag: https://drandyroark.com/store/

All Links: linktr.ee/DrAndyRoark

ABOUT OUR GUEST

Matthew Salois, PhD is currently the President of the Veterinary Management Groups (VMG), where he is responsible for enhancing the economic and cultural success of more than 2,000 veterinary member practices. Most recently, Matt was the chief economist and head of the veterinary economics division at the AVMA between 2018 and 2022, where he applied his skills in economics, business, and communication to support the daily lives of veterinarians. From 2014 to 2018, he served as senior director of global scientific affairs and policy at Elanco Animal Health. Matt is also an adjunct professor of applied economics at the University of Florida, where he previously taught and advised graduate and undergraduate students. He earned his Ph.D. in Applied Economics from the University of Florida and holds an M.A. in Economics and a B.S. in Health Services Administration from the University of Central Florida.

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 fun business nerdy episode today. It’s me and Dr. Matt Salois. Matt is the president of VMG, the Veterinary Management Group, and we are talking about the possible resurgence of the independent practice owner.

We went through a period where corporate consolidation was happening and we were seeing corporate groups buying and buying and buying practices. And that has slowed dramatically. Are we seeing the independent owners coming back now? Has the landscape changed enough that it is favorable?

Are there people who want to own their practices independently? Matt says there are, and I want to believe him. And so we get into that and kind of what the demographics look like for practice going forward. We talk about, we talk about what practice might look like in the future. He talks about three big drivers that are sort of driving an independent practice resurgence.

And then we talk a little bit about the future and what the next five years might look like. And so anyway, it’s a good, honest conversation with some good stuff and maybe some stuff that’ll keep you awake at night if you’re a practice owner, but it’s all mixed in there. So anyway, I love having that on.

So insightful, such a wealth of knowledge. Let’s get into this episode 

Kelsey Beth Carpenter: 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. Matt Salois how are you?

Matt Salois: I’m doing great. Good to see you again, Andy.

Dr. Andy Roark: You as well. I always love having you on the podcast. I was at VMG and I was hanging out with a couple of my friends. We were, I think I don’t remember looking at the program or what but your name came up and someone that I respect said You know, I would go wherever that guy was to hear what he had to say And it was just very complimentary statement about how insightful some people that I respect find your commentary.

So anyway, I just I was like, I gotta get, I gotta get Matt back on the podcast.

Matt Salois: That was a plant. That was the person that I put in there to do that. Yeah. No, just kidding.

Dr. Andy Roark: There was money, traded hands and, here.

Matt Salois: Yeah. No, appreciate that. It’s always great to be on here. I always feel like I’m on the premiere daytime talk show for veterinary medicine. When I come to talk to you, I love it.

Dr. Andy Roark: Well, thank you for saying that. I just, I genuinely am always interested in kind of what your thoughts are. You pay a lot of attention to the industry and which way it’s sort of going. And especially trends around practice ownership and independent practice ownership.

You are the president of the VMG, Veteran Management Groups, and you just generally have your finger on the pulse of, kind of, independent practice ownership in a significant way. And so, I’ve had this idea for a long time, and I, think independent practice ownership is a just, important. It’s a vital part of our culture in vet medicine and I just, I always want to support independent practices.

I mean, I don’t have any problem with corporate practices as well. I think that there’s a good mixture and there’s a lot of benefits for a mixed model like we have, but I still want to, I don’t want independent practice to go away. go away. And there for a while, there was so much consolidation and private practices were being bought at such a high rate of speed.

A lot of people were like, how far is this going to go? And we’ve seen a slowdown in that regard. It’s probably over, you know, increased interest rates and, money is more expensive to borrow now than it was. But, I just anecdotally, Matt, I had this feeling that we’re starting to see possibly an upswing in independent ownership.

We’re starting to see some consolidation has slowed down. We’re starting to see maybe some people who sold their practices, three, five, years ago are now sort of circling back around and saying, I think I’d like to make another pass at this. And boy, I’ve learned a lot of lessons. And now I’ve also got a nice chunk of change that I could play with to get something started.

It reminds me of, you know, if you’ve ever built something. And then you look back at it and you’re like, I love it, but boy, I could build this in one third of the time now that I know what I’m doing. And I hear that sentiment a lot from people who have sold practices. So let me sort of stop talking here for a second.

I just want to put it to you and sort of say, Do you share my optimism in the idea that maybe there’s a pendulum swing? And maybe we saw independent owners sort of exiting the field and maybe now they’re starting to come back in? Or do you think that’s maybe wishful thinking on my part? Yeah.

Matt Salois: No, I don’t think it’s just wishful thinking. It’s like this conversation was meant to happen, Andy, because you’re not alone in this. In fact Martin Traub Warner and I gave a talk at the PSI Symposium just this last past October on this very topic, you know, our title was Independence Day.

Why the conditions are right for a Renaissance of independent veterinary practice ownership. And it’s just on this entire thesis of what you’re talking about. And our genesis for this talk was, A year long experience that Martin and I were having what you just shared was owners who had sold to corporate coming back and reopening new independently owned practices because they could do it like you say, to the third of the time they could do it twice as well as they did it before, as well as some of the promises that I think that the corporate buyout just never, revealed themselves.

You know, and I think this is a Time tested story. You might’ve heard, Martin and I have heard it around, you know, I sold to corporate, they said nothing would change the culture, remained the same. They promised the practice to grow and some of the promises just didn’t happen and things did change. The culture of the practice wasn’t the same.

And they didn’t like the way things were left. And so it wasn’t just a do over for them. It was, Maybe amending the sins of the past and doing something again that they wanted to create this practice and how they felt a practice should be run and what a culture of that practice should look like.

Dr. Andy Roark: Well, so do you think that so I’ve heard this story before as well And I believe that there’s truth to it a lot of cases. How much do you think it is that? People who sold their practices again when you talk about corporates, that’s like talking about independent practices as if they’re all uniform And so just wild differences and so We’re, it’s, a big stereotype here, but, people have this have, you know, have that sort of story that they tell, but I gotta tell you, Matt, when I look at it, you know, having run businesses.

I don’t have clarity of what the next year is going to bring. And you know, and when you’re building a business and you’re putting things together, I do think that you could have the best intentions to say, we want to maintain what’s here. We want to maintain this culture, but none of us have the foresight to get in and you look and, who knows what’s going to happen in the world or who’s going to leave or, who’s going to come in or be brought in to run a region or a group of hospitals.

And there’s just so many moving parts. I have a hard time. In some cases, you wonder if that was ever really the plan. In most cases, I think it probably was the plan, but it just doesn’t shake out that way. And so, how much of that, if you own a practice and you sell it, how much of feeling that way is unavoidable?

Because it’s never going to stay the same as it was. Like, even if you ran it, it still wouldn’t be the same as it was. But, how much is that? How much it is, oftentimes, A lot of people and I go through this too, I a hundred percent, so I still work in practice. I was in the vet clinic today seeing appointments as an associate and I romanticize being an associate.

I’m like, Oh man, I could just go back and I could just roll in and see appointments and go home at the end of the day. But the truth is I can’t, I could never give up the control that I have. Like I just, I couldn’t do it, but I tell myself I could. And how much of it is that, you know, We, you sell your business and then only then do you really realize how much you enjoyed being the one who got to make decisions or you got to be the final decision maker.

Matt Salois: I mean, that has to be a part of it, right? Because, and we see this carry out in the data, AVMA and others have shown, they look at some of the wellbeing metrics around compassion fatigue and those sorts of measures compassion satisfaction, and they’re higher for, Practice owners and they are associates.

And while it may sound contrived in a way, but it’s true owning your own destiny, choosing the path that you’d want to walk. There’s value in that. There’s reward in that. And, you know, to your point around corporates and totally not meant not meaning to use the word pejoratively. I don’t think we should or should do that at all.

But they’re wildly different. And I think promises are made with always the best intentions, but this is part of the challenge with corporate ownership. You have to look at who owns that business, who owns that organization. And for the most part, there are plenty of exceptions, but for the most part, most of the corporate practices are owned by private equity groups in veterinary medicine.

And their whole fundamental purpose is, revenue return, to buy something, invest in it, and then sell it for a return. And so these practices change ownership hands, you see it time and again with NVA and others who are emerging the equity owners change, they’re selling to one another, and the priorities of those equity owners may be different, or how they strategize and build a strategy on practice growth could be wildly different than the previous owners.

And so it’s hard to have that consistency over time when the ownership of that business or that practice is changing hands too.

Dr. Andy Roark: That totally makes sense. Shifting gears a little bit. Talk to me about this conditions are favorable for independent practice ownership. Start to talk to me about what that looks like in your eyes.

Matt Salois: So I think it’s a number of things. The first thing and you alluded to it is just the economics of things. The fact that interest rates have reversed themselves definitely changed changes the tide in terms of what’s happening with consolidation. So the pace of consolidation has slowed way down.

The cost of capital is a lot different than what it used to be. Like you said before, money’s, money was really cheap and now it’s more expensive. Interest rates are coming down a bit from the highs of the last year or so, but we’re still amongst, you know, 20 year high interest rates for our economy, so it’s a lot more expensive to invest to gobble up practices, whereas before, particularly post covid immediately when interest rates were actually negative for a period of time because of some of the actions by the Federal Reserve and fiscal policy from the government, it made interest rates effectively negative, which is just odd.

We do have occasions of that in our economic history, but they’re generally pretty rare. So the incentive to sell a practice, I think, first and foremost, is a lot less than what once was. And so I think that’s slowing things down and creates a incentive motivation for a lot of independent practices just to focus on their practice and their growth rather than sell.

And on the flip side of that, From the corporate perspective, now the business isn’t investing in, in, in practices and growing through number of practices. Now they have to be business managers here. Now they have to be the owner and an operator of a veterinary practice. That’s how they, need to grow.

That’s a very different mindset. So I think that’s why we see a lot of corporate struggling right now. The other piece of this, the second piece I’ll say is technology access and affordability of technology has never been more accessible. Never been more affordable. And so the things that corporates could have done on their own because they had the capital, they had the cash the most expensive equipment, the best systems, the most cutting edge.

That’s not in the domain of the corporates anymore that I think independent small business in general. can access those types of technologies to incorporate into their practices. I mean, chat GPT is, it’s cheap, right? And so just the ability of AI and other types of technology to use that in your practice, no longer the domain for large businesses.

And the third and the final thing I’ll say is the level of support. And services available within veterinary medicine has matured greatly. And so, what that means for an independent veterinary practice is they no longer have to have their own tech department. They no longer have to have their own marketing department.

They don’t need their own bookkeeping. There are all these organizations and companies and services that can come in and support a veterinary practice in so many ways, allowing them just to focus more. On the delivery of the medicine and the patient care. So I think those are the big three ways that Renaissance is happening.

Dr. Andy Roark: Yeah. I like this a lot. I really, it’s funny, as I sit and think a little bit about the level of support and services, I think you’re, I think you’re spot on. 

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These courses are made to be taken. in groups, they have discussion questions. They are all about taking these trainings and getting them to apply to your practice, your culture. And your clients, whether it’s handling angry clients. Or being effective in the exam room. We’ve got some great training resources that you can grab and drop and use pieces of. 

They’re all broken up into five minute modules to make it super easy for you to use what you want and skip over what you don’t want. Tag them onto the end of staff meetings, or just make a whole staff meeting out of the trainings. Anyway, super flexible. It’s DrAndyRoark.com/teamtraining Gang, let’s get back into this episode. 

Dr. Andy Roark: You know, it was funny for a long time, the narrative was that you were going to see vet practices getting bigger and bigger. Yeah. because there was an economy of scale and you could have this technology if you had five, six, ten veterinarians using it.

So just imagine, you know, that we were all going to get CT scans. Well, one vet could never support a CT scanner, but if you had 20 vets, then they could, between them, they would have enough cases that would justify the cost and you could have this equipment. But that’s not really the way that medical technology has gone.

It has really shifted more and more towards being more and more portable, affordable, you know, sort of a subscription service type model. Um, And that, yeah, that’s, I think you’re spot on. I think that’s really powerful. I think the ability to outsource a lot of the services is really exciting in a lot of ways.

You really, you don’t have to wear all the hats because all of those things are readily available. I think that’s, I think that’s. I think that’s interesting. Can you speak a little bit about what the real estate market looks like for veterinary practices? It used to be that, you know, vets tended to own the real estate, or they tended to have standalone buildings.

And then there was definitely a shift in the, you know, late 2020 or early 2010s. We started to see a shift towards these buildouts in sort of strip malls, you know, kind of, startup spaces and things like that. Do you see or foresee build outs of those clinics in those types of rental spaces going forward?

Is that making practices more accessible if you wanted to get one set up or is it having a, you know, a sort of a net neutral effect?

Matt Salois: Yeah, that was a good one. And there’s a lot in there. I think, 

Dr. Andy Roark: Yeah, I kind of threw a lot, I kind of threw a lot at you around around where do we put vet practices?

Matt Salois: I think there’s a lot of opportunity in real estate. I mean, the real estate is one of those goat rodeos right now. I mean, it’s coming back, but it was a hot mess the last couple of years. In particular, you look at office real estate and commercial real estate, like there’s huge vacancies there as a lot of work from home, hybrid, remote, conditions evolved and are sticking for the most part. You still have some employers pulling back on that, but that’s another conversation. There’s a lot of vacancies, and so I think there’s a lot of opportunities for small businesses to take advantage of what a lot of real estate owners are doing, which is, you know, reducing their rents.

Or reducing some of their prices in order to have that real estate move. And the housing market, that’s a completely different story. And that’s a completely different market. But when you look at the available real estate for a veterinary practice, I mean, there, the availability is out there and many are building standalones.

And we’re having that within VMG. And I will say. I don’t know enough to know which one is dominating, but within our member practices, we’ve got members who are probably all over the place in terms of, you know, are they in a strip mall or in a, you know, organized commercial real estate venue versus are they standalone practices?

And we know, I know that there are plenty of members who are opening and expanding their own standalone veterinary practices too. I think there’s a lot of potential, a lot of opportunity there.

Dr. Andy Roark: Where do you think the new sort of wave of practice owners will come from? I mean, if it sort of shapes up this way, are these people who are later in their career who are circling back around? Is there a new wave of sort of entrepreneurs coming in who are maybe veterinarians? Who have come into vet school with this sort of dream or, I mean, give me an idea of what is, what demographics do you see sort of driving a potential resurgence in independent ownership?

Matt Salois: Yeah, all over. Quite honestly, which is a good thing. I’ll say again, bring up my VMG perspective as we’re seeing the membership get younger. And we have for the first time tipped majority female in terms of our members. And I’d have to look at the AVMA trends to see how that squares more generally with practice owners in the profession.

But it’s growing amongst that, that demographic makeup of being younger, being women. And you know, it sort of has to in a way because we’re more and more, you know, women dominated the profession and we are getting younger. We’re seeing this in the workforce, not just the veterinary workforce, but in our general workforce as you know, 11, 000 plus boomers are retiring every day.

So they will exit. Now, I’ve seen this in veterinary space more than in other industries and professions. The retirement age seems to be a lot, further out than, the typical you know, 62, 65, particularly when you look at some things like equine and food medicine, food animal medicine.

But we’re seeing that too. We are seeing owners step in who were previous owners, like we talked about, sold their practice, took some time off, decided that wasn’t for them. They were too early to too young to retire. And so now they’re opening new, businesses, new, veterinary practices, and they bring a lot to the table.

So I think we’re going to see a very strong mishmash who those owners are and what their demographic makeup is. Yeah.

Dr. Andy Roark: Do you think these people are going to be cranking out practices that are your standard companion animal practices like we’ve seen for the last 20 or 30 years? Or do you see a different sort of iteration coming down the pipes? 

Matt Salois: It has to evolve. I think there’s no question about it. In terms of the business model, in terms of, you know, how you run a veterinary practice, what you focus on and what you don’t, I think the specialization of veterinary medicine is going to continue that we’re going to see more and more

specialized, targeted veterinary practices, whether that’s at a, you know, specific specialization or even just focusing on, a specific species. You know, exotic pets, cats only, dogs only, those types of veterinary practices. We’re seeing that again within VMG that specialization, we’re, actually starting for the first time an urgent care group within our membership because they’re just growing number of urgent care, specifically veterinary practices. They’re not er, but they’re not general, right? they’re, urgent care. And so I think that caters to almost the consumer trend we see in the economy as a whole is people want the product or service designed for them.

And so you have this ability now to go onto a website and get almost anything Customized to what you’re looking for now. There are limits within health care, which is what veterinary medicine is. But as someone like Peter Weinstein keeps pointing out, it’s consumer health care. You know, so we’re at this hybridization of healthcare and almost, you know, retail in a sense that yes, it’s healthcare and it’s complicated.

And it’s also a consumer market in the sense that you have consumers who want things on their terms and they want it their way and veterinary medicine is going to have to adapt to that. And we are, it’s not easy, but we will, we have to.

Dr. Andy Roark: I do agree with that. I saw a lady today that was very well informed, and had very strong opinions about what she wanted for her pet and what she did not want for her pet. And, you know, it was not worth wrestling to the ground and her opinions were not, they were not detrimental in any way, but she was just, it was, I laugh not because she was wrong, but just because she was very particular and very certain about what she wanted and, you know, that’s not entirely new.

It’s definitely not going away. I think the age of sort of self education in pet owners is here to stay. I think I think we’re probably gonna be dealing with even a more educated level of pet owner than we have in the past going forward. Just accessibility, it’s easy to ask Chat GPT, what might be wrong with your pet and come in with a list of five things that are fairly well thought out.

Matt Salois: Yeah, exactly. Right. You know, gone are the days where you’re happy going into Target or Walmart and you’re pleased with the variety of what’s being offered to you now. And so I think, you know, again, you go to the Amazonification of everything where there’s thousands of options for that one product that you’re looking for.

Yeah. But people are wanting that. People are wanting to know that what they’re doing, what’s being provided to them, has been provided to them as an individual, this increasing individualization that seems to be occurring, you know, in our demography and in our markets.

Dr. Andy Roark: Yeah, when you look into your crystal ball five years from now, what do you see? I mean, do you see a steady steady march of sort of independent practices coming back in different niches? Do you see a specific type of practice really kind of jumping out ahead? What are you most optimistic about in the next five years?

Matt Salois: Oh, that’s a good one. I think most optimistic is that, you know, veterinarians are going to be in need of veterinary professionals in general, and it’s not just for the companion side. It’s all these things that veterinarians provide their skills and their talents towards on food safety, public zoonotic diseases, anything related to the one health arena.

Veterinarians are so important to our society. And I think the continued renaissance of the human animal bond. will grow. I mean, we’ve seen that. We saw that through COVID. Yes. I think that’s going to continue and sustain itself. I do think from a business and economic perspective, we’ve got volatile times ahead.

And so veterinary practices are going to have to, like any business, rise up to that challenge. They can’t just be about the veterinary medicine. I think gone are those days where you can be a practice owner and just be focused in your head, buried in the medicine. That is first and foremost, always the most important that you’re delivering the best care possible to patients.

The challenge now is that you’re going to have to be an astute, savvy business owner manager in order to survive. I think those volatile times because we’ve been through them, we’re going to, we’re going to see more of that and every business is going to need that fortitude.

Dr. Andy Roark: Yeah. Talk to me a little bit more about this volatility that you say. You say there’s volatility coming to tell me a little bit more about that so I can lose sleep at night.

Matt Salois: Yeah, so you could lose sleep at night. So I mean, I think, well, first of all, there’s always a business cycle and we’re going, we’re approaching the downside of our cycle. You see that with the softening of visits, yeah, there’s revenue growth, but it’s by far and large, you know, price driven. 

Dr. Andy Roark: Price increases.

Matt Salois: Right. And so there will be a market correction. That’s always the case. There is always a next recession. And we shouldn’t be afraid of it. It’s just part of the natural cycle. It’s hard not to talk about what’s going to happen next and leave out all of the complicated things that’s happening in our economy, in our society, the increased polarization, the inability of monetary policy and fiscal policy, excuse me.

To get us through some of those difficult times. We bought our way out of the oh, eight recession. We bought our way out of COVID. You see this when you look at aggregate debt levels in our country. And so there is a ceiling here in Japan hit it and we saw. The stagflation that Japan experienced for quite literally decades and only now, you know, since the eighties, only now, really, are they coming out of it and potentially seeing a new era in their economy and that’s my worry for, our, economy as well.

We’re also, we talked about the demographic change, that’s going to be hard. We’re going to see the non working population explode relative to the working population. And so what that means for services like social security and medicare, there’s going to be a funding problem. And, you have the confluence of these forces.

Excuse me, the doorbell rang and the puppy, the little puppy that we got for Christmas is, uh, barking up a storm. She was napping so peacefully next to me and now she’s on guard dog alert. That was sweet little Molly. She’s actually quite sweet. So those are the issues that we’re facing and they’re all going to be kind of at a confluence in the next five to 10 years as these forces are coming together all at once.

Dr. Andy Roark: Well, I think that’s no, I think you’re spot on. I appreciate you sort of sharing that. I think it makes sense. I I, love owning my own business. It’s not easy. I am surprised by how not easy it is sometimes but it’s rewarding and it’s something that I really have enjoyed. So anyway, Matt, thank you so much for being here. Where can people find you? Where can they learn more about VMG?

Matt Salois: Yeah, that’s great. A joy to be here. Talk to you Andy. I always get so much out of our conversations. I’m available LinkedIn. I’m active on there. Message me really to reach out to me. And you can learn more about VMG at our website, myvmg.com.

Dr. Andy Roark: Great. Well, I’ll put links in the show notes, guys. Thanks for tuning in, everybody. Thanks, Matt. Take care of yourselves, everybody.

Matt Salois: You too. Take care. Thank you.

Dr. Andy Roark: And that’s it. That’s what I got for you guys. Thanks so much for being here. Thanks to Matt for being here I’ll put a link to his LinkedIn and the VMG website down in the show notes And that’ll be that gang. Take care of yourselves everybody.

I’ll talk to you later. Bye

For this week’s episode of the Cone of Shame Veterinary Podcast, we’re bringing you a cross over! Dr. Cassi Fleming from Vetfolio Voice interviews Dr. Andy Roark about a recent article, Sharing Your Crystal Ball. Together they discuss how veterinary leaders can share their vision of the future to foster development and growth.

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

LINKS

TVP Article: https://todaysveterinarybusiness.com/crystal-ball-discharge-notes-0224/

Vetfolio Voice Podcast: https://www.vetfolio.com/pages/podcast-landing-page?utm_source=hero&utm_medium=card_podcasts&utm_campaign=vf_hp

Leadership Essentials Certificate: https://unchartedvet.com/certificates/

Uncharted on the Road: https://unchartedvet.com/on-the-road/

Charming the Angry Client Course: https://drandyroark.com/charming-the-angry-client/

Dr. Andy Roark Swag: https://drandyroark.com/store/

ABOUT OUR GUEST

Dr. Cassi Fleming is a triple Gator, earning her Bachelor’s and Master’s degrees in Animal Science, as well as her DVM degree from the University of Florida. While in vet school, Dr. Fleming earned certificates in Veterinary Business and Food Animal Medicine. Despite originally planning to enter dairy practice after vet school, Dr. Fleming unexpectedly found her calling in small animal general practice. While she still loves all things cows, she greatly values the close relationships she has formed with her clients and their beloved pets. Dr. Fleming worked as an associate veterinarian for the first six years of her career before making the transition to business owner and taking on her role as “Dr. Cassi,” Staff Veterinarian at NAVC’s VetFolio. In addition to her work in the continuing education field through VetFolio, Dr. Fleming is the owner of Springs Veterinary Services, a small mobile general practice, and a part-time associate at Newberry Animal Hospital in Newberry, Florida, where she focuses primarily on dentistry in addition to general practice. Aside from her love of dentistry, Dr. Fleming is passionate about arthritis management and fostering and protecting the human-animal bond.

EPISODE TRANSCRIPT

Andy Roark: Welcome everybody to the Cone of Shame veterinary podcast. I’m your host, Dr. Andy Roark. Guys, I got, uh, I got some fun for you today. I was interviewed at the VMX conference for the Vetfolio voice podcast and my friend, Dr. Fleming was talking to me about an article I wrote on sharing our crystal ball. 

So I had this idea that there’s something really powerful in sitting with people and telling them a realistic view of how you could see them developing in the future. And I don’t think that we do that very well in that medicine. I think we just say, keep paddling. But we don’t really share with people how we could see them growing and developing and practice. 

And that doesn’t necessarily mean we have to change roles or we’re going to create a new job position that doesn’t exist. But everybody wants to feel like they’re going somewhere and we should talk to people about what’s possible and what we see them doing well, and it’s always hard to see ourselves. 

So having somebody else say, I really see you growing in these areas. And I think your strengths are really here. And this is how I could see us using those strengths or where I could see you going or how you could continue to develop and stay engaged and do new and interesting things in medicine. I think that stuff is really powerful and we just don’t do it a lot. 

So, Cassi and I have a really big conversation on that. I think it’s a really good conversation. I do talk about what a bit about my, leadership essential certificate, which I made with uncharted veterinary conference. It is on Vetfolio. I made it for anybody who leads or manages other people. 

And so if that’s an area that you could see yourself developing into, check it out for sure. it is the absolute best, advice I can give to somebody it’s eight hours, RACE CE, self-paced modules. But anyway, we do get into that a little bit as well. So it’s a, nice talk about just general growth and development inside of clinical practice, where maybe you can just keep moving people to new upward positions. 

We have to grow. Inside the area that we work in. So anyway, that’s it. I hope you guys will enjoy it. I think it’s really fun conversation. Let’s get into this episode. 

Kelsey Beth Carpenter: 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. 

Cassi Fleming: Well, I’m excited to wrap up these live sessions with the always fun and insightful Dr. Andy Roark. Thank you for joining me. 

Andy Roark: Thank you for having me. 

Cassi Fleming: Absolutely. So we’re gonna kind of dive into this topic related to an article you wrote in the upcoming issue of today’s veterinary business called sharing your crystal ball.

Yeah, I was lucky enough to get a sneak peek at that article and read it ahead of time. It’s got a great message. So will you talk to us about the article and the messaging and the inspiration behind it? 

Andy Roark: Yeah, sure. The, the idea of sharing your crystal ball is this, If you, want to keep people engaged in your practice and you want to make them feel like there’s a future for them, they have to be able to look into the future and say, there’s a path for me.

And so, and so sharing your crystal ball is about talking to people about their future and where you see their future. And you have to do it in a certain way because we don’t know the future. We don’t know what’s going to happen. And you can set expectations. But then you don’t meet and people are upset because, Hey, you said I would get this opportunity or hey, you said I would get to do this thing and I didn’t get to.

And so you really got to be careful about, seeing those expectations. And that’s why I let a lot of people lean back because they’re like, I don’t know what’s going to happen. So I don’t want to talk to people about where they’re going, what I see them doing. But, I’ll tell you the saddest things that happened to me in my career.

I was, at the clinic and there was this technician who I really felt had a very bright future on the floor. And she came to me and, she said, you know, I think I’m going to leave. and, I said, you’re going to, you’re going to leave the practice? And she was like, I think I’m going to leave vet medicine.

And I said, well, why? And she said, well, I don’t want to be Sandy. And I said, well, what do you mean when you say you don’t want to be Sandy? Now, Sandy was a surgery technician at our practice, right? And she had been there for like 30 years. And, she had always been the head surgery tech for like 30 years.

And this technician said to me, she said, Sandy’s been doing the same thing every day for 30 years, and I don’t want that to be my life. And I don’t want to be Sandy. And so I think I’m gonna leave. And, ultimately, we, talked a bit about, kind of, what her options were, and, you know, some people really like routine, and they like to stay where they are.

But I think one of the greatest problems that we have in vet medicine, especially retaining our technicians that are so vital is there’s got to be a path forward. Like nobody wants to stay stagnant where they are. Everybody, like we’re a profession of learners and growers and people who want to be challenged, right?

And so I don’t want to be sandy to me means I don’t see a path forward for me. I don’t see challenges for me. And so when we talk about sharing our crystal ball, we need to, it all depends on who we’re talking to and what they want and what they value and what excites them. But at some point, we’ve got to peer into the uncertain future with them and say, This is the path for you.

This is the new fresh path for you and this is kind of where I can see you going. And I just think that’s absolutely mission critical in staying engaged for a lot of people. And so anyway, I just, I think that we have not done that well in vet medicine in general. I don’t think we’ve done that well with associate vets.

We’ve told associate vets, hey, the path for you is practice ownership. And that’s not really the path anymore. and there’s a lot of people who are great associate vets and they never wanted to own a practice. But that was the only next step that they had. And I think that, that’s flawed the same thing, especially with my technicians.

We say, well, Hey, you’re an assistant, go get your CVT, go get your LVT. And then they do. And then we’re going to do the same job they were doing before they got their CVT or LVT. That doesn’t make any sense. And then, you know, we say, well, what’s the path for a technician, a licensed technician, a loud and proud licensed technician.

It’s to become the practice manager and you go, those things are not remotely the same. Like, nothing about being a kick ass technician makes you ready to manage a building or a team. Like, not that’s bad, I love managers. It’s just, they ain’t the same. And like, the idea that you got to go from here, the next step is this.

That’s a problem. The other alternative we see is industry. It’s like, oh man, you’re a phenomenal technician. You should leave and go and work in, industry. And again, no shade on industry at all. I think that you see techs going into management as a default and you see them going into industry as a default because they don’t see a path that keeps them actually on the floor learning and growing and developing and getting better.

And I think that is a fundamental problem that we have to address in Vet Medicine. 

Cassi Fleming: Right, yeah, basically to say either go into management or leave are not good options to be the only options going forward. I think of kind of an analogy that I think of in the form of a joke from a comedian. I promise it won’t sound like a joke because you have to get it in context.

But basically he says, if I was a really good cook, it wouldn’t really be fair to say, great. You’re a great cook. Can you farm? Like, no, those are completely different skill sets. So. Why are we trying to transition these technicians into management positions unless that’s something that they really want with appropriate training?

Andy Roark: Well, there’s, a need for it, right? Like we all, want to work for a good boss, which means somebody has to step up and be a good boss or somebody has to step up and be a good manager. and so it’s, there’s definitely a need and we look around and we look and we have highly competent people and we say, I think you could do this job if you wanted to.

So it comes from a good place. But I mean, we all know veterinarians that did not want to own the building and didn’t want to own the business. But the other vet they worked for retired and everybody needed jobs. So somebody’s got to own this thing. And that’s how they became a practice owner. And that was our culture in medicine for a long time.

Again, that’s not coming from a bad place, and it should be flattering if you’re, you know, you’re a tech or you’re, an assistant, associate doctor, and somebody says, I think you would be a wonderful leader, like, you should be proud of that, but also, it doesn’t make a, ton of sense, and again, I, the thing I love the most about medicine is, you know, it’s a house with a million rooms, and like, You know, my career has, been a picture of that, of just finding these kind of weird things to do and then doing something else and doing something else and doing something else and still being able to come back and practice and, it’s just, I think that’s one of the joys of medicine, but a lot of people don’t see that.

And so we talk about sharing a crystal ball, like we need to show them what that path is, right? We need to show them the other rooms besides. Moving off of the floor into something that’s, not really what you’re passionate about or excited about. And so the way that we do it is, pretty specific.

So when I started to talk about showing people your crystal ball, I think we need to be having more developmental conversations with people. And I think the leaders that we currently have need to get a little bit better. And not when we have our one on ones or we, do our, sort of development meetings.

It shouldn’t be so much about giving feedback on what happened in the past. As much as it’s talking about where I see you going or what your opportunities are going forward. And so just think about it for a second. if I was gonna give you feedback and I could come to you and I could say, Hey, last week, I don’t think your animal handling skills were where I wanted them to be.

And I’m, I didn’t feel like you were as patient as you could have been. And we need to work on that. That feels pretty bad, doesn’t it? I’m glad that they said it. Give me feedback. I want to have it, but it doesn’t feel good. Versus if I come to you and say, I want to talk to you about kind of where I see you going in 2024.

And, I really like, I think the area of focus for you is going to be an animal handling and low stress handling. I think that there’s an opportunity for you to grow here, to pick up these skills, to improve. And I would like to invest in, in training for you. I think in that area is an area that’s going to really help you and is going to move you forward and keep you learning in a way that’s going to be really valuable to the team.

How does that sound? And doesn’t that feel much better than, I think, Your animal handling skills are weak, and I saw them last week, and we need to fix them. Versus, I see an opportunity for us to go forward together, and this is how I think we could kind of use you. It’s also sharing the crystal ball to say, hey, you know, I don’t know what will happen or what sort of promises is, but I want you to know that I see you as a very strong communicator, and a really good leader.

And if you wanted to take on some leadership responsibilities, if you were interested in becoming our head CSR, our lead technician, I think that those are skills that we could start to train towards if that was something you were interested in. How does that feel? Are you interested in something like that?

And do you see how I’m painting a picture of where we could go? Isn’t that engaging? You know, when we start to talk about, like, what it looks like to continue to be in the practice. And it’s not, hey, I really think you’d be great in industry. It’s, hey, I really think that as we learn and grow, these are the opportunities.

And I see these paths. We start talking about sharing your crystal ball. There’s, a couple of different ones. there’s a, there are medical paths and then there are leadership management communication paths. And I think that we can really look at people and talk to them about what they like.

But I think that there’s, so much opportunity to develop these areas out of, Hey, let’s, look together at where we ought to go. And this is area of opportunity. I really think that you could grow in, or these are strengths that I think you have that I would really love to see you continue to develop because I think you could be exceptional.

In this area, and I’m really giving this person feedback on what they’ve already done, but boy, it feels so much better than, hey, these are your big three weaknesses, and these are your two big strengths that I saw in the last year. It’s just, it’s a different type of conversation, but it’s changing from a critical conversation, which is past tense, to a developmental conversation that’s future facing.

And again, I always couch this with, we don’t know what the future is. But this is kind of where I would like us to try to go where I see us going in the next three months, six months, 12 months, something like that. And then it’s starting to get into the skills of like, what do they want to learn and what would be valuable for us to learn?

And I need to put words to those things or else they’re still kind of lost about where I’m trying to get them to go. 

Cassi Fleming: If only there was like a course or a certificate or something like that taught about, you know, giving feedback and growing your team and, you know, retention and all these different things.

Andy Roark: Well, yeah. So over the last couple of years, I have been working with lots and lots of hospital leaders and multi hospital leaders on how to really make their practices run and how to make them be very high functioning, performing practices with really good culture. Really good culture is important to me.

And so I put myself to a challenge, about a year ago and I thought to myself, I wanted to sit down and I wanted to try to grow someone and show them a path for development. That would involve them leading or managing other people. And the truth is, we’ve always done this thing in our practice where we said, “You’re the best tech, you’re now in charge of managing other human beings.”

Which again, it doesn’t make any sense. Those are not the same things. And we throw them in the deep end, sink or swim, figure this out. And that’s never made any sense to me. And so I sat back like about a year ago and I was like, Okay, I have taught literally thousands of doctors and, techs and lead techs and practice managers medical directors and owners and, what are the things that I genuinely truly believe that anyone who’s leading or managing other people should be trained on. And I came up with about eight hours and it’s all broken up, but basically. You’ve got to be able to build and maintain trust with people.

Everything we do is built on trust. That’s how you’re effective in the exam room. That’s how you get doctors to delegate to you so you can do things. It’s how you can get your technicians to jump in and perform for you. It’s how you can get people to be vulnerable and honest and to ask for feedback and to listen to feedback and take it.

It all has to be done inside the context of trust. We have to trust each other. And so trust building is important. There’s basics of strategic planning. When we talk about, when I talk about strategic planning, I talk about where we’re trying to go, but a lot of times I talk about who we are and like, what are our values, right?

Are we a practice that’s built on the highest standards of patient care? Or are we built on, on supporting our community? Or keeping care affordable and accessible? Or are we lifelong learners? Or are we customer service champions who make the patient and the client experience the best it can possibly be?

You can be any of those things. But you can’t be all those things. It’s not right or wrong, but if I know who I want to be and who my team wants to be, we can come together and say, Guys, how do we live these values, right? We say compassion is what we care about. Is it really? Tell me about a time in the last two weeks you saw someone on our team actually demonstrate compassion.

And guys, that’s a powerful conversation to have because it really does make people say, well, Cassi did this yesterday and that’s us living our values and there’s great pride in that. But if you can talk to people about values and understand the values of your team, you can really start to decide where you’re going as a team in a way that people buy into.

And so team buy-in is another part of it. So many people show up and try to tell other people what to do, and that’s not motivating at all. We need to show up and talk to people about what their problems are, what the pain points are, what’s not working in our practice. Or what we’d like to see better.

And then we need to come to work together with our teams and ask them, Do you guys have solutions? What do you think we should do about this? And listen to them, because they’re on the ground and on the floor and they know what the pain is. And if they come up with the solutions, they’ll own those solutions and they’ll be their solutions.

And it’s so much better to get a solution that your team comes up with, because it’s theirs, than it is this great idea that you have that you try to get them to do. And so team buy-in is just so important. Nobody tells us how to give feedback. Nobody tells us how to say, Hey, I need you to do that a little bit differently for me.

And it’s a weird, awkward conversation. And our profession is so, like, adverse to, to conflict. There’s so many of us who don’t like conflict. I’m one of them. But there’s a really good way to say to people, Hey, I need you to do this a little bit differently. And say it in a way that’s not bringing conflict.

But nobody tells us how to do that. It’s just this simple thing. The fact that we talk about feedback and everybody thinks it’s negative. That just is insight into like, this is a problem because when we, I always say, you know, I don’t care who you are. You’re a simple animal. We’re all simple animals and guys, we know how to train simple animals and it’s positive reinforcement.

And so if I want to train my bad dog, Skipper Roark, to do something, I don’t wait until he messes up and yell at him. That’s dumb. It’s not good for him. It’s not good for me. I figure out how to start catching him doing what I want and how to reinforce it. Right? And I’m there and positive reinforcement and positive reinforcement guys that works on us.

But so many of us, we just think about when we talk about giving feedback, we immediately think about negativity. We can do so much to lead and grow people with positive feedback. But you just have to know how to do it and you have to just decide to lean into it. You got to learn how to set priorities, like, so many of us are trying to do all the things and you can’t do all the things.

You’ve got to be able to look at your day and say, this is ridiculous, not all this is going to happen. And so what are we going to do? And what are we not going to do? When was the last time you stopped doing something in your practice? Like we keep adding things to it, but we never like, you know what?

We’re going to stop doing this. And that’s a problem, but that’s priority setting. And so like, those are the types of things that are in the Leadership Essentials course. Cause like you got to have those skills to get people to, to grow and be comfortable leading. And like, I don’t know, it’s one path. But it’s a path that I think can make people really comfortable.

I, I really think Cassi, I’m sorry, I’m sort of, I’m fired up about this now.  

Cassi Fleming: No it’s a great course, I was going to say. I’ve done many of the lectures in the course and, you know, I think what made me think of it just then was your talk about forward facing, feedback and making it future oriented, that made a lot of sense.

You know, setting priorities and things, I’m going, what do you mean, it’s not good to just like make this huge list of priorities that you can’t get done and then beat yourself up at the end of the day that you didn’t do anything effective when really you did at a lot of things. 

Andy Roark: Well, I’ll give you a silly example, so I’m a to-do list guy, right?

Like, I like to make to do lists, but I always get up and I’ll keep the to do list and the to do list will have 19 things on it. And at the end of the day, I feel like a failure every day because there’s no way I’m going to do 19 things. If I do three things off my list, especially big things, that’s a great day, but I don’t look at it that way.

I have this list of 19 things. I do three things and feel like a failure, and it’s dumb. And so I think that type of clarity of saying, all right, let’s be realistic about what we’re doing today and what we’re going to push off and plan to do tomorrow. And if I say, well, these are the three things I’m doing today, and then I’m going to move in and do some other stuff tomorrow, and then I do the three things, I feel like I succeeded.

But a lot of that is just picking that thing and putting it forward. But again, it’s, I think a lot of us, I think a lot, and this comes from old school practice, but a lot of us came from a, get it done culture and like, that’s where I came from is like, Hey, we just get, we get it done.

The clients come in and we get it done. And that works when you’re not overwhelmed in how busy you are, you know what I mean? But a lot of us got pushed past capacity and then get it, just get it done. You can keep that up for a day when you’re overwhelmed and maybe a week and maybe a month, maybe three months, but ultimately you’re going to break.

You can’t just get it done when you, when the pets don’t stop coming in. At some point, you got to make hard choices. I’m all about us helping other people. Like, God, that’s the meaning of all of this is, how do we help other people? How do we make a positive difference? But I think the hard realization I came to in my life, I went through a period of burnout in my early 40s.

You can’t pour from an empty cup. Like, you, you’ve got to still give to people. But you have got to give with intention. You have to say, this is what I can do with this is what I can do today. And that has to be enough. And I am better off calling it here and coming back tomorrow, ready to go again, that I am pushing back and coming back tomorrow, being tired, being resentful because I’m tired of being away from my house or my kids or whatever.

But it’s that type of priority setting. It’s not easy. And there’s ways to do it, right? It’s not just how do I feel today? It’s What is important? What is important to our mission? What is important to the values? What is important to my team? What is important to my clients? What is the easy thing that I can do that will have a big impact for my team or for my patients or for our community?

Like, it’s, picking those types of things. What is the thing that if I do it, then that frees up other people so that they can then go and work independently and we can get so much more done. I call that the closed door model where you look and you say. if I, if everything I have to do is a door, how many people are standing outside of each door?

I want to open the one that has the most people standing outside of it, because all those people can then go forward and do the stuff beyond that door on their own. And the impact of what we do is much bigger. But it’s just having some strategies like that you can look through and say, how do I pick these things off of this list?

And I don’t know, again, I don’t think anyone sits down with most of us and says, let’s go through your options on how you can decide what you’re going to do today. Yes. 

Cassi Fleming: And, you know, once again, here we are talking, I feel like every time we talk, it’s exactly what I need to hear and what I need to talk about.

But I will avoid monopolizing, like tell me more about priority setting and how I can do it better and pivot back to, to growing people because I think when we exercise these types of strategies, we’re talking about growing that team, retention, team buy in. So now, you know, we’ve done this and we’ve got our team buy-in, but there’s still the Sandy factor, we will call it.

So how, you know, once we get that buy-in, how do we then grow our team members without that transition to management, that transition to industry or specialty or whatever it may be? 

Andy Roark: Yeah. So, one of the real reasons I would go back to, to, to sharing your crystal ball. One of the reasons I really love this is that when I start to do something like this, I’m giving this forward facing feedback.

Okay. And I’m saying, Hey. This is kind of where I can sort of see you going in the next year. What do you think about that? Do you like that? And they would sort of say, oh, yeah, I do like this or I don’t. We would sort of talk back and forth. And then what I want to do from there is start to crystallize in the future.

What does the next step look like? And again, I think one of the things that people get wrong about development is a lot of us think that we, we’re where we are right now. We are going to become something else. And then the credits will roll and we’ll live happily ever after. You know what I mean?

Like, a lot of us are like, I see so, okay, I’ll just pause here for a second. Let me jump to veterinarians for a second. I will talk to these vet students, right? And they’re in their last year of vet school, and they are completely paralyzed, deciding, am I going to do an internship, or am I going to do a residency, or an internship, or am I going to go directly into GP?

And they just eat themselves alive, trying to figure out, am I going to do this, or am I going to do that? And the truth is, it doesn’t matter that much. And I know that because I’ve surveyed thousands of veterinarians and I said, two questions. Did you do an internship? Yes or no? Are you happy with your decision?

Yes or no? And I found that 97 percent of people who did an internship are happy with their decision. And 95 percent of people who did not do an internship are happy with their decision. And so my takeaway is for the most part, it’s probably going to work out for you just fine. But here’s the thing, you’re going to do an internship and then you’re going to decide what you’re going to do after that.

Or you’re going to go into GP and you’re going to be a brand new vet. And then you’re going to decide what you’re going to do after that. But guys, you’re all signing one year contracts. And that’s all it is. It’s a one year contract. As you said, you were gonna do this, we’re gonna do it for a year, we’re gonna see how it goes.

And that’s all it is. But there’s so much pressure we put on ourselves, I am committing to being this thing, that I will then be forever. And this is not how it works. And so when we talk about this, and one of the reasons I like to say, Let’s, talk about what success for you looks like at the end of a year. One year from now we’re sitting together and we’re talking and things are going great.

What does that look like in your mind? And I, and that’s how I started to frame it up. And it’s because it’s fairly low stakes. I’m not saying what are you going to be when you grow up and say, what are you going to be one year from now? It’s a fairly small step, but it’s still a step in the right direction.

And then also we’ll start to talk about it. And sometimes I’ll say, Hey, I really see you doing. Well, in this way, I really see this for you and they’re not totally convinced. They’re like, I don’t, you know, I don’t know. And I’ll say, how about this? Let’s try this for a year. Let’s go in this direction. Let’s work on these skills.

And then at the end of the year, you can say, you know what? That’s not really, I didn’t love it that much. Let’s think about something else or let’s kind of circle back around and see what our needs are then. And it’s just so much nicer to not push people to make a. What seems like a full life commitment, you know what I mean?

Cassi Femming: Yeah, I do.

And so, so you can start that way, but that’s the beautiful part about vet medicine, especially is, you know, I was doing a talk on keeping care affordable and also practicing good medicine and also paying our staff more. And it kind of feels like this paradoxical thing of like, how do I pay my staff more and keep care affordable?

And the answer is well leveraged technicians practicing at the top of their license. And we have to shift general practitioners up as well. So we need GPs to practice at the top of their license. Which means general practices need to probably keep more cases that we’re currently referring away.

We can offer referral. We probably need to hold on to some of those cases, work those cases up. We need to get more comfortable doing surgery that is appropriate for us to do. But we as doctors need to be working more at the top of our license. And that allows our technicians to work at the top of their license.

And it keeps care down for pet owners. Because they’re getting services, but instead of a doctor that charges, say, 75, 80 an hour, they’re working with a technician who charges 30, 35 an hour, and we’re able to make those things make economic sense because we have different care providers doing it.

And so, we have to make that, we have to start to make that shift. When we look at how we make that shift, when we look at some of the things, we’re just gonna take the technicians, for example, the ability to have technicians doing physical therapy, rehabilitation. It’s huge. The fluorescent light, derm treatments, the like fovea, things like that, for example.

Our technicians can do that. If anybody’s done tele guidance ultrasound, where you do the ultrasound and the ultrasound tech says, turn your hand this way or tilt it that way or blah, blah, blah. There’s no reason for our doctors to do that like we can, but, your technicians can do that and boy, if they do it three, four times a day for seven weeks, 10 weeks, six months, they’re going to get pretty darn good at it pretty fast.

And now we’ve got technicians in our practice doing ultrasounds. And those are cases that we’re working up at the general practice level and it works and it makes sense like that. But the sky’s the limit really about what we want to do. I worked with a practice in New York and I went up there and I met a technician who was there and she loved rehab and the idea of physical therapy and rehab.

And she had to push and push on the practice owners to get a chance to do it. And finally they gave her a closet at the back of the practice where she could keep her stuff. And that was about five years ago. When I went up there, they were clearing land to build her a building. Next to the practice because she had blown the whole service up like that.

And when people were doing surgery at the practice, they were getting rehabilitation tied on to that surgery of, Hey, we’re going to come out. We’ve got you in for some rehab sessions and things like that. 100 percent technician driven. But man, you talk about the ability. Is that an engaged person in your practice?

Absolutely. They got multiple technicians now in rehab and she’s managing and leading because she went from the provider up to overseeing these other people. But she’s still, she’s got this mixture of leading something she believes in and also still getting her hands on it. But I mean, that’s success.

That’s amazing. The pride that I see in technicians that do ultrasound, like this is what I do. And this is the value that I bring. And, you know, the reports come out and go to the doctors, but. This is something that I have trained myself in a year or two years. That’s what I’m talking about, but it’s not necessarily certification.

You can do a VTS, you can go and get a specialty, but, and a lot of times I don’t think that’s necessarily what you need. It’s really about what does your, what do you want your experience and practice to be? And then what do you need to have that experience? I think a lot of us, first of all, we wrestle with imposter syndrome, and we’re like, I’m not qualified to do this, but if I had a piece of paper, or if I sat in a class, then I would be qualified.

And I can tell you in my experience, that emotion doesn’t go away. I see a lot of people who go when they do the class and they’re still there. They’re still scared. And I see other people who say, I’m gonna train myself and see if I can do it and work through it. and they do it, but in one way or another, I think a lot of times it’s about choosing what you want to know.

And then making a plan, an intentional plan on how to get there and setting some waypoints of. This is we’re going to get to this level and then we’re gonna get to this level and then we’re gonna get to this level. So I don’t know if I answered your question. I sort of hope I did, but that’s kind of where I see those paths going and what they look like.

Yeah, 

Cassi Fleming: No, that absolutely answers my question. And I guess I see it as like a joint project between upper, you know, whether it’s the practice owner, practice manager and technician kind of working together to say, you know, what, are our practice values? What do we want to accomplish? And what do you want to accomplish?

What do you like? And then working together to kind of find that common goal. When you, put it out in a talk like this, like, it’s like, of course, that makes tons of sense. What do you think the roadblocks have been to making this a reality in a lot of scenarios so far?

Andy Roark: Yeah, so that’s, oh man, that’s such a good question.

So there’s a lot of different roadblocks. one of the big ones is a lack of creativity or a lack of willingness to sit and say, where do we want to be in a year? And just being intentional about it. Not what you want to be when you grow up. Exactly right. Not what you want to be. Just, What, what does success in a year look like? And I think a lot of times we don’t ask ourselves the right questions. And so, I think people, again, I, don’t think it’s a failing as much as we’re all just busy and we’re all just trying to get through the day as fast as we can. And we, you know, you know how it is, when you look at like financial planning or end of life planning or things like that, it’s not exciting stuff and nobody wants to spend their day and sit down and think about the future necessarily when we’re all busy right now.

But all that stuff does pay off in a big way, and it’s the same thing, you have to have somebody who wants to be intentional about where they’re going as opposed to reacting. I think one of the big problems with vet medicine is if you, let it be what it is, you will always be reacting. You know what I mean?

Vet medicine does not follow the schedule, it doesn’t matter what’s on the appointment schedule, that’s not what you’re going to end up seeing at the end of the day. Like what you see, I stopped looking at the appointment schedule the day ahead of time a long time ago because it never represented what my day was going to be like.

And it’s because you’re just reacting. And so, if you just show up and take that medicine as it comes, you’re always reacting. Freedom, if you want to be free, if you want to be able to go home and be home at the end of the day and be like disconnected, you’ve– that only comes from intention. It only comes from looking ahead and saying, what is the plan?

What is, what do I want, what do I want my life to be like? Because if you don’t have that thought, then you always end up going, well, this is just. What happened to me, and now this is where I am. And so anyway, I think that lack of intentionality is a really big one. I think, systematically, culturally, the fact that most of us didn’t get trained or developed that way means it never even occurs to us to try to train or develop someone underneath us that way.

You know what I mean? Like, most of us got tossed in, sink or swim, and that’s all that we know. And so, we toss the next person in, or sink or swim, because that’s what we did. And I think some of us kind of feel like, well, I did it this way, so you should have to do it this way. But I don’t think most of us do.

I really do think that most of us just go, this is the only way I know. And so we learn from being tossed in ourselves and we learn from having a horrible experience with a bad boss. And you’re like, I’m never doing that to somebody else. And those are like the main drivers in how we know how to train people or grow people.

So I think those are big ones. And the other thing that I think too is, I think a lot of us wait for permission. And we wait and we say, well, no one has come to me and told me that I have this potential, that I could be amazing in this way. And so I’m going to keep kind of doing what I’m doing now until someone shows up and tells me I’m good enough to grow myself.

Or develop myself. And I think it takes a certain type of person to go, I don’t care. you know, I love behavior. And I am going to go on Vetfolio and just take behavior CE and I’m going to talk about it in the exam room. I’m going to start working on it. I’m going to try to get the practice manager to let me do virtual behavior consults for our practice because I love it.

And I would just, let me have just a couple of clients to get started. Let me try it. And a lot of people just don’t know that they don’t have to wait for permission that they can advocate for themselves. And, they also don’t know if they advocate for themselves and say, I want to do this and then energy goes, you know, I, no, we’re not going to do that.

They don’t know they can go somewhere else. This is true. And so, I mean, again, it’s sort of shifting worldview, but all of those things I think are things that are obstacles to people. and, but they can all be navigated. It’s just, I don’t know. It’s just, you, just, you have to believe in yourself.

You have to believe that you are capable of learning and growing and being better and you have to, you want to, I think a lot of us have to, we have to push to advocate for ourselves and a lot of people are not comfortable with that. And then I think as leaders, we have to stop and say, it doesn’t matter that this wasn’t how I was developed.

It wouldn’t matter that I didn’t have these resources. These resources are existing now and I want the people that I lead to have a better experience, a smoother, faster development than I had and make that happen. But it just requires intentionality. 

Cassi Fleming: That makes a lot of sense. 

Andy Roark: Hey guys, I just want to talk to you real quick about the Uncharted Roadshow in Atlanta. I am going to be there with Stephanie Goss and Maria Parita and Tyler Grogan and we are going to be doing the Uncharted Leadership Essentials Certificate. That is, uh, it is two days, it is 14 hours of race CE. You heard that right, it’s packed in there.

It is workshop style CE. We will be doing understanding the trust economy. We’ll be doing strategic planning, vision and values. We’ll be doing communication styles, feedback and coaching, achieving team buy in, setting priorities, getting priorities done. That means holding people accountable and setting timelines and deadlines.

We’re going to be doing all of that stuff. You are going to be, uh, drinking from the fire hose and it is all about you actually getting the skills. As I said, it is very, very, very, very hands on, you are not going to be sitting and getting lectured at. You are going to learn, you are going to be a different and better leader when you leave than when you arrived.

That is a Sunday and a Monday in May, as I said the 5th and 6th in Atlanta. Grab yourself a spot, they are going to sell out, um, I would love to see you there. Alright, let’s get back into this episode. 

Cassi Fleming: Two things kind of came to mind listening to you.

One, it’s just thinking from my own experience, like fear of failure, you know, to say like, oh, I’m gonna do this. But now that I said I’m gonna do it, now I really actually have to do it. I would love to hear your thoughts on that. Because I know, you know, that’s been a roadblock to me in times in my life.

And I hope I’m not the only one out there.

Andy Roark: On fear of failure?
Cassi Fleming: Fear of failure. The other thing that I thought about, well, I’ll hold that. I’ll hold the next one I thought about. I’d love to hear your thoughts on like that. If I put it out there, then I Have to deliver and what if I can’t, what if it’s not what I thought it was kind of that mentality.

Andy Roark: Oh man. So I think, so I, so let me tell you two stories if that’s okay. So the first story, I told these stories in one of my lectures earlier here at VMX, and that’s why they’re at the top of my mind. But, the first one’s called the Sword of Damocles. Have you ever heard the Sword of Damocles story?

Cassi Fleming: I feel like I have, but remind me.

Andy Roark: So, okay. So it’s the Sword of Damocles. The idea is there’s this guy named Damocles. And he goes to the king, and the king is Dionysus III. And Domicles goes to Dionysus, and he says, Man, you’re in such a great place. You’ve got this awesome stuff. I wish I was the king. I wish I had the power that you do.

Man, you’ve got it made. This is just such a cool thing you have. I would be so, oh, it would be so amazing to be you. And the king kind of looks at Domicles and finally says, You wanna, be the king, Domicles? And Domicles says, Absolutely. And the king says, Alright, come back here tomorrow.

And you’re going to sit on the throne, and you can be king for a day, and we’ll trade places. And Domhnacles is like, yeah! And so he goes away, and he comes back, and the next day it is as the king says. And so Domhnacles sits on the throne, and everyone does what Domhnacles says. But there’s always a catch, right?

And so over the night, the king went and he took a sword, and he hung it by the hilt so the blade was pointing down, and he hung it over the throne by a single horse’s hair. And the sword just dangled there over Damocles head. And Damocles just could not take it. The idea that this sword was hanging over his head.

He couldn’t, he did not enjoy anything as this sword dangled over his head. And finally he just cracks and he’s like, I take it back. I don’t want this. I don’t want to sit in this chair. I want to trade back. And he traded back. And the idea with the sword of Damocles is, the king said, that is what it’s like to have power.

It’s you have this sword dangling over your head. And so if you ever hear someone talk about, she has the sword of Damocles over her head, it means it’s this feeling of this sword over her head. And when I read that story originally, I felt that so much because I think so many of us practice with the sword of Damocles over our head.

It’s this idea that disaster could strike at any moment. That there was yes, I have power. Yes, I have knowledge. Yes, I can do great things, but you don’t understand how badly these things could go or how disastrous this could be. And that, that, that fear, it is so pervasive in our practice, in our practices, in our culture.

It drives so, we can’t make a mistake. We can’t make an error. And it’s cultivated in how we’re trained in vet schools and tech schools. Like, we are. perfectionists, but perfectionism is driven by fear. And so there’s so much fear that just drives our profession. And I think that’s a real problem. And so I think a lot of us are driven by the sword of Damocles.

So, what’s the alternative to the sword of Damocles? I went on vacation to Nova Scotia this last year with my wife and my daughters. And so we went up to Nova Scotia. We were gonna hike and camp and backpack. And before we went, my wife said to me, “I desperately want to see a moose. Like, I have never seen a moose. I would kill to see a moose.” And I was like, “you know what, baby? We are going to find you a moose.” And so we flew up there and we got a rental minivan and I got the kids together and I was like, “Kids, we have one mission while we’re up here and it’s to find your mother a moose” and they were like, let’s do it And so we went to work hiking and camping and finding this moose and we popped up early because the moose are out first thing in the morning and so we’re out and we’re hiking in the morning before breakfast and then we’re staying out and we’re hiking after dinner because we read somewhere that’s moose o’clock when the sun is going down And so and we were like we’d hike past people on the trail and be like hey do you see any moose?

And then when they would be, no, or I saw some footprints or whatever, we talked to everybody we saw. We asked every park ranger where the best place was to see the moose. When we drove, we took shifts so that someone was always scanning the tree line as the other person drove to make sure if there was any moose like standing in the forest by the road, we would see them.

And for 10 days, we looked for that moose 24?. And, at the end of the vacation, you know how many moose we saw? 

Cassi Fleming: I’m gonna go with none. 

Andy Roark: Not one. Absolutely zero moose. And so we came back, and I came to realize two things on that trip. The first one is that moose are not real. They are fake. They were created by the park service and Canadians to lure us into remote places.

Cassi Fleming: I always had a suspicion.

Andy Roark: Hashtag moose truth. That’s, what it is. And so just know like, you know how some people think the moon landing was faked.

Cassi Fleming: Yeah. 

Andy Roark: That’s moose. The moon landing, totally real. Moose on the other hand, no. Exactly. But I understand how those people feel now because I get it. But it says number one moose are not real.

Number two is everybody should have a moose. Everybody should have a thing that you’re like, I’m going to find this. I’m looking for this. I will get out of bed to go and find this moose. And I will do one extra hike at night because I really want to find that moose. And the difference between the sword of Damocles and having a moose is everything about how you see practice and how you see life.

You don’t have to be motivated by fear. You don’t have to have the sort of domiciles hanging over you and you’re worried. What if it doesn’t work? What if it fails and it’ll be catastrophic? What if you see a moose? What if you go and you find it? What if it’s there? What if it’s everything that you hope it is?

The worst case that happens is you go and you look and you know what happened? You know how my vacation turned out? It’s the best vacation of my life. Because we did all this stuff. Because we talked to all the people. We went all the places because we were together and we had something to talk about.

But you can make practice that way, but you have to have the moose that you’re looking for. And so when you start to think about the fear of failure, it’s the decision of it. Am I going to be motivated by the sword of Domincles and I’m worried if I move, then catastrophe will fall upon me? Or are you going to get out of bed and say, we’re going to find a moose today.

And even if we don’t like what we find, we’re still going to go looking. You know, we’re going to go out, we’re going to see what’s out there. Maybe we’ll see it and maybe we won’t. But we’re going because I want to find, I want to see if we can find a moose. And so I know that’s kind of a silly way to answer your question about what do we do about this fear of failure?

Part of it is you have to decide what your moose is, and the moose is what makes failure worth it, you know, and it’s that focus, it’s that perspective shift, but I think everybody should have a moose. 

Cassi Fleming: I don’t think that was a silly way to answer it at all. I think we all learned a little bit about moose here today.

Andy Roark: About moose or the lack thereof. 

Cassi Fleming: The lack thereof, moose truth. It makes me think of, like Dale Carnegie, the, you know, just, he has how to stop worrying and start living. And one of his principles is, you know, accept the worst case scenario, just right off the bat. Decide like, okay, what does this look like if it fails?

And accept that like, that is a real possibility and what is that going to do to you? Yeah. And that has been really helpful for me to say like, okay, let’s say this whole thing blows up in my face. Like that, I’m, you know, putting myself mentally in that position. And most of the time I’m like, Okay. I could deal with that. That’s okay.

Andy Roark: There’s benefit to having terrible experiences. And I know that sounds silly, but it’s true. Those horrible clients that chew you out and they’re awful. The one benefit to it is after you’ve been chewed out a couple of times, the fear of being chewed out kind of goes away because I’ve been chewed out before, you know,

Cassi Fleming: I’ve seen worse than this.

Andy Roark: And it’s exactly right. And you go, Oh, I’ve been worse than this. I’ll tell you a slightly inappropriate story, but I was, I was speaking yesterday. And this, this young lady flagged me down before I started and I went over and I said, Yeah, and she said, Do you remember Texas A& M? And I said, Were you there?

And she was like, Yeah. I threw up on stage at Texas A& M’s College of Medicine one time. I went, I got food poisoning and I went and I was lecturing to the students. And all of a sudden I got really hot and like I felt sweat pop out on my back. And I stopped and I said, guys, I’m just gonna be honest with you.

I may have gotten some food poisoning. So if I have to leave and they were all, they all thought it was a bit, they were like, where’s he, going with this story? And, I said, if I have to leave, that’s why. Actually, where is the restroom? And they all pointed at the same time. And right then, I just, I threw up.

And so I slapped my hands over my mouth and I turned and I run towards the restroom. And this guy in the front row goes, Turn off your microphone! And so I’m trying to get my microphone. So it was a horrible experience. It was the worst thing ever. But, the, And she was there and she was like, “I was there.”

And, at the, but the shining light around it is whenever I feel insecure about going and talking to people, or whenever I feel unprepared, I look at myself in the mirror and go, it won’t be as bad as Texas . And, then I go. You know, but it’s that, like, it’s this horrible thing. So I think that’s a big part of it.

I did an exercise one time. Because I was kind of, I was kind of wrestling with some existential dread, sort of Damocles, over my head, right? And I took a time, I took some time, and I sort of came up with it actually myself, but it really worked well. And I wrote down in a journal all of the times that I thought that things were going to go or could go catastrophically bad.

I wrote down all the times in my life I was really worried or I thought things could be potentially terrible. And I wrote down in one column all the times that I thought that they could be potentially terrible and they actually were terrible. And I wrote down all the times that I thought they’d be terrible and they worked out okay.

And the truth is I had nothing on the first page and everything on the second page. All the times that I thought this could be really bad and it worked out okay. That was a long list. And there was nothing on the other list. And I just, for me, that, that really made the point. And I will look back at it every now and then and be like, these are all the times I was afraid.

And they worked out just fine. And even if you’ve got one or two of the times you were afraid and it didn’t work out okay, I promise you that list of times it did work out are so much bigger. And that was just, it was something I just kind of stumbled onto playing around with, but that really did something to reset my perspective.

Cassi Fleming: Absolutely. Well, and even if it doesn’t work out the way that you foresaw it working out the way that you planned it, that you didn’t follow your path, a lot of times it still works out. Okay. Even if it doesn’t look like how it was supposed to look when you started out.

Andy Roark: Oh, absolutely. Well, you know, it’s, it’s funny.

We set these expectations about what is going to be, and I know I’m not the only one who sets expectations that are always at some polar extreme. It’s either, this is an amazing success, you know, or this is a complete and total failure. And in my life, every single time, it has been somewhere in between.

But when I think about things and imagine things, I imagine the worst scenario and the best scenario, and then I jump back and forth between those two. Very rarely do I imagine something that’s in the middle, but I’ve gotten much better about that in my forties. I’ve got, I just, I’ve gotten a lot better at looking and saying, well, what is the worst thing that could happen?

And I think that’s actually a healthy thing to say, this is catastrophic. And then what is the best thing that can happen? What if it’s amazing? And then what’s a realistic in between. And honestly, that exercise in itself usually helps me to come out with a fairly realistic, you know, point where it’s probably going to end up.

Cassi Fleming: Yes, I feel like I’ve learned this so much from watching my daughter who is, poor thing, she’s my mini me, like I feel so bad for her. But you know, she has that same perfectionist personality that I’m gonna guess there’s probably a few people out there who can relate to that and you know, so I watch her and she, you know, if it’s not perfect, then it’s a failure and I’m like, no, it’s not, a failure and Watching her has taught me to give myself grace and say, okay, well, if it’s okay for her, it’s okay for the rest of us as well. That it’s not a perfection or failure. 

Andy Roark: One of the things that helped me a lot in this is, somewhere along the way, I aspired to talk to myself the way I would talk to my employees or to my team. And man, I say things to myself I would never say to someone I worked with. Like, absolutely never say. And I will say it to myself and just the idea that and you would not say that to someone who you were trying to lead or manage and so don’t not say it to yourself.

And that was, that’s been something that’s been really healthy because one of my longtime friends has this saying, you know, I would say something to her like, Oh, I’m an idiot. And she would say, don’t say that about my friend. And I love that she would interject that and don’t say that about my friend.

And I interjected that because it would make me stop and recognize that I was using self-talk and I was not being fair to myself or kind to myself. You know, it’s funny, I’m seeing a rise in people who are reading about stoicism. And when I started reading about stoicism, this idea of, basically it’s kind of focusing on the problem is the path forward.

If there’s something that makes us uncomfortable, we should focus on that problem. What is that problem? What is in my control? What can I do about this? And sort of how do I address challenge his head on and move forward. And so that’s sort of stoicism in a very sloppy nutshell. But, basically, you know, when I thought about stoicism, I kind of imagined it was sort of being mean to yourself and suck it up and things like that.

But one of the key tenets of stoicism is self love and self grace and to say, I’m going to treat myself as well as I would treat my best friend. And I’m going to give myself the grace that I would give to my spouse or to my friend. And I thought that was really interesting that you would have this very problem focused philosophy, but behind it is not be hard on yourself.

It is be kind to yourself so that you can focus on this problem and be okay. And I don’t know. I just, I think that’s, I think that’s really important. I don’t think that we give ourselves nearly enough grace. I think that’s sort of the flip side of the coin. I think a lot of us beat ourselves up and I think we also look at other people to tell us that we’re doing a good job.

And I think that’s really a toxic combination of I’m going to be as hard on myself as possible. And I’m also not going to be happy unless other people tell me that I’m good. My clients tell me I’m good. My staff tells me that I’m good and I’m going, good God, man, you’re giving all the power to be happy to other people.

And then you’re also cracking this nasty whip on yourself the whole time. What are we doing? Right. But it’s such a common philosophy. I just, I really think we need to, I think a lot about what success looks like for us as individuals, and then we need to be kind to ourselves, and we need to talk to ourselves the way that we would try to talk to our children, right?

I love my kids, and I want them to be successful, and I tell my kids when I need them to change, or, you know, I try to give them honest feedback and make them really good people. But boy, I should try to talk to myself with the kindness that I talk to my children, and I hold my children accountable.

And I coach my Children and I support my Children. I tell my Children when I’m disappointed, and I expect better from them. Why don’t I communicate with myself? Why don’t I hold myself to those standards with that grace or with that support or with that love? So anyway, but I think a lot of us wrestle with that.

And, again, I think we’re, some of us are so driven and we’ve just bought in so much to being perfect in the outcomes that we achieve. That we’re just become these nasty taskmasters to ourselves. And I think it’s something we have to address as on an individual level. But, I really do think that we can get there.

I think most of us learn along the way at some point, you know, we kind of put our hands up and say, this isn’t worth it. Something will come and it will change your perspective and it will show you what’s really important. And I think that a lot of us get that adjustment at some point in our life and go, Oh, I’ve been really stressing out about things that were maybe not the things I needed to be terrified of.

Cassi Fleming: Yeah, when you really think about what’s important. Yeah, I can relate to that negative self-talk very deeply. I have to get up an hour before the rest of my family because I’m not nice in the morning. I can’t interact with people kindly until I’ve been up for an hour and had a cup of coffee.

So sometimes I’ll find myself, I’ll wake up in that time and I’m stressed out my head’s already spinning by the time my feet hit the ground. I’m like, oh all this stuff and everything and then I’ll you know I’ll sit down and I’m drinking my coffee It turns out I’m also not nice to myself in the morning, but I’ll have these thoughts and then you know Every now and again, it’ll strike me.

I’m like, of course, I’m stressed out Of course, my head is spinning like listen to how I’m talking to myself and how mean I’m being like I wouldn’t like you said I would never be this mean to an employee, to my children, to a friend. And so why would it ever be okay for me to talk to myself like this? 

Andy Roark: Yeah. I think it’s, I think it’s pervasive. I think a lot of us are that way.

Cassi Fleming: Yes. Obviously we could sit here for like, you know, all evening and chat about all of this. So I will wrap it up by just asking any final thoughts you want to share with everybody? 

Andy Roark: No. I, well, I’ll say this. I love our profession.

I love that medicine. I am really optimistic about the future, Cassi. I really am. I think change is scary. And there has never been a time in vet medicine where things have changed as much as they’re changing right now, and I think that’s terrifying. But guys, I really do believe that there’s a bright future on the other side.

Is it going to be catastrophic? Is it going to be perfect? No, it’s going to be the thing in the middle. But I just, I really do think that we’re headed for a good place and for bright days ahead. And just, yeah, I just, I, love what we do and, just the amount of innovation that we’re seeing in our profession now as far as treatments and diagnostics and just, it’s unprecedented.

And so I think we have a choice to make about how we feel: we can be terrified because change is scary, or we can, or we can lean in and decide that we’re going to be excited about what comes out the other side. But at the end, we choose if we stand under the sword of Damocles or we go searching for the moose.

It’s a fascinating time to find a moose that you care about and go look for it. 

Cassi Fleming: I love it. I love it. And I do, just as we wrap up here, I do want to point back to your certificate one more time. Promise. I’m not being paid to point back at your certificate, but it’s a really good, you know, mainly from the standpoint of, as I went through the lectures, you know, I’m somebody who wants to give that productive feedback and to help grow people in the roles that they’re in.

but I don’t know how to do that effectively, maybe because of, you know, the experiences that I’ve had, maybe because I’ve just never been taught how to do it the right way. So that, I just want to point back to it and say, you know, it was, I found it really insightful to say, Oh, this is what I want to accomplish, but I don’t know how to give me good techniques to accomplish those goals.

Andy Roark: It’s been years and years of working on it. When I made it, I really did want to make it for anybody who leads or manages other people. Where I’ve seen people snatch it up immediately is especially people who, who are new leaders and they say, I’ve never had any management or leadership training and I need something to help me figure out how to say this or how to tell people or how to ask them for things without them getting defensive.

It’s just those types of basic things that are absolutely critical to success. No one trained you how to do it. So it’s, I see a lot of new leaders and I see a lot of other people who maybe the manager or the medical director or the owner is looking at them and saying, I think this person has a lot of potential.

But I don’t know how to support them as I give them more opportunities to, to move into leadership or decision making or management. And they say, aha, this is great. It’s eight hours. They can work through it on their phone. When, you know, over is in like five minute pieces. So you can work through it.

And those are, the people though, the brand new, the new leaders and the people who are moving into leadership, they get it right away. They want it, they grab it, but those have been the people who have been the early adopters for sure. 

Cassi Fleming: Well, it’s a great program and I’m glad that we got the chance to talk about all of this.

This has been a fantastic talk as always, but I’m glad we got to bring that up too because I think it is a really good resource out there. Well, thank you. 

Andy Roark: And that’s it guys. That’s what I got for you. Thank you so much to Dr. Cassi Fleming for having me on the podcast and for that folio for putting this together, guys check out their podcast. 

This is a, if you liked this conversation, you would probably like to hear. Cassi talked to some other people and, and they really do a great job and they have a great podcast. So anyway, check out vet folio, voice, wherever you get your podcasts. And I will talk to you guys later on.