Team Culture

Those You Know, But Don’t Know

November 15, 2023 by Andy Roark DVM MS

When I used to drop my kids off at daycare, my primary focus was ejecting the children from my car so I could get on to my mile long to-do list. Screeching tires, flying gravel and… was that a little girl wearing a halloween costume in March? I passed through the parking lot as quickly as possible.

From an efficiency standpoint, this was great. I was knocking things off the list and making stuff happen! From a relationship-with-daycare-workers-and-other-parents, it was pretty bad.

Relationships are funny and fickle things. You can’t put them on a checklist and mark them off. You can’t show up, say a compliment and walk away. No matter how charming you are or how much corporate communication training you’ve had, building relationships takes time. It requires doing the work to know another person. Putting in the time of simply being together. There are no shortcuts.

I spent years as a veterinarian ducking into and out of exam rooms like a game show contestant navigating an obstacle course. I took great care of pet owners and pushed appointments quickly and efficiently. But at the end of the day, when my technicians would go home, I had no idea where they went. I didn’t know what they did, or who met them when they got home.

I knew the people I worked with, but I didn’t really KNOW them. I knew their competencies and behaviors. I knew their quirks and what made them laugh. I didn’t know, however, what they cared about, how they thought, or what they aspired to become in the future. I didn’t know what they wanted to accomplish before they died, what their most meaningful life experience had been, or what made them proud at the end of the day.

I regret not knowing those things.

I think a lot of us believe we don’t have better relationships with the people around us because we don’t have time to build those relationships. I’m not so sure that’s true. Recently I’ve been pondering the idea that maybe it’s not time that holds us back. Maybe it’s a lack of curiosity. Maybe we forget to wonder about people we see everyday. Or maybe we’re just too shy to ask people about themselves.

In my experience, most people are thrilled to have someone want to know more about them. They smile and open up. They feel special and seen. Asking deeper questions so we can better know others isn’t a weird thing in practice. Instead it’s usually a path to deeper, more trusting relationships.

Who do you know, but don’t really know? What could you ask them today to start to make that journey?

When Vet Techs Consider Leaving the Field

October 19, 2023 by Andy Roark DVM MS

Dave Cowan and Jeff Backus, Emergency & Critical Care Veterinary Technician Specialists and the hosts of the Vet Tech Cafe podcast, join Dr. Andy Roark to talk about when veterinary technicians consider leaving vet medicine.

Both Dave and Jeff were considering walking away from vet medicine when they met and decided to start their own podcast. Since then, they’ve learned lessons and gained insight on how to keep technicians engaged with vet medicine (and also when it’s just better to go ahead and leave).

Let’s get into it!

Cone Of Shame Veterinary Podcast · COS – 230 – When Vet Techs Consider Leaving The Field

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

LINKS

Vet Tech Cafe Podcast Homepage

Dr. Andy Roark on Vet Tech Cafe

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

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

Dr. Andy Roark Swag: drandyroark.com/shop

All Links: linktr.ee/DrAndyRoark

ABOUT OUR GUESTS

Dave Cowan BA, CVT, VTS(ECC) has been in the veterinary field for over 25 years. He has worked for an educational farm, the Animal Rescue League, general practice and emergency/specialty practices In 2013, Dave passed the Academy of Veterinary Emergency and Critical Care Technician (AVECCT) exam and became a Veterinary Technician Specialist (VTS) in Emergency and Critical Care. He moved to North Carolina in 2016 and has spent time as a technician supervisor, an education and training coordinator, and was lead instructor for a Veterinary Technician Program. In 2019, Dave co-founded the Vet Tech Cafe Podcast with Jeff Backus. The podcast tackles difficult issues that veterinary technicians face as well as highlighting some of the many career opportunities available to technicians. Dave joined Action Vet Tech Services in 2020 and now works relief shifts at various practices both ER/referral and GP while also providing CE and training opportunities

Dave has served on the New Hampshire Veterinary Technician board as the head of the credentials committee. He has been the chairperson of the AVECCTN credentials committee and is now one of the Members at Large on the AVECCTN Board. Dave lives in Hillsborough NC on a farm with his partner Robyn and her daughter Ruby. They have many animals to care for including goats, horses, chickens, and a donkey to go along with 2 dogs, and 2 cats., I have a one year old daughter.

Jeff Backus started as a veterinary assistant in general practice in 1995 and began working in ECC in 2004. He became an RVT in 2009 and VTS(ECC) in 2013. Jeff also taught veterinary technician education for 7 years. He has been on the Board of Directors for the California RVT Association for 8 years, serving as President position from 2020-2022, and is now past President. After 4 years in academia at Tufts University, he relocated back to Southern California with his wife and began working for the ASPCA Animal Poison Control Center. He is also a frequent lecturer and speaker with a focus on toxicology. He co-founded the Vet Tech Café podcast with Dave Cowan in 2019, talking about issues that face the veterinary technician profession with leaders in the field, and all of the amazing opportunities of the veterinary technician profession.

EPISODE TRANSCRIPT

Dr. Andy Roark:
Welcome everybody to the Cone of Shame Veterinary Podcast, I am your host, Dr. Andy Roark. Guys, I got two friends in today, Dave Cowan and Jeff Backus, they are the host of the Vet Tech Cafe Podcast, we talk about that a little bit getting started. And we come in and I started to talk to them, I want to talk to them about lessons learned from their years of interviewing mostly veterinary technicians and we immediately found the path that I was really interested in, which was when they talked about when they met each other and were both basically burned out and thinking about leaving that medicine. And I said, “man, is that common, do I hear that from technicians, including boarded technicians like they are, I just hear this a lot of, I reached this point and I was thinking about leaving the profession, I was ready to get out.”
And so we stopped there and just started to unpack the lessons they have learned about when we reached the point of thinking about leaving the profession. And so we get into that, we talk about headspace, we talk about all the people that they’ve interviewed, and what lessons they’ve learned, and what keeps them engaged and things like that. But it is really an interesting conversation, it’s a lot about technicians specifically, but it’s also a lot just about burnout, it’s about the stresses of our profession, and it’s about the idea that just because you have done something, it doesn’t mean that you have to do it forever. Just because you’ve been in that medicine for 10 years, that doesn’t necessarily mean that you have to continue practicing as you did for the rest of your career. I think a lot of times we put that weight on ourself, but it’s not real, we make it in our own minds. So anyway, that’s the episode, that’s what we’re here talking about, so guys, let’s get into this.

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

Dr. Andy Roark:
Welcome to the podcast, Dave Cowan and Jeff Backus, how are you guys?

Dave Cowan:
We’re doing great, how are you doing?

Jeff Backus:
Yeah, doing well.

Dr. Andy Roark:
I’m doing really well, I’m glad that we could sit down and talk. For those who do not know you, you are both veterinary technicians, you both have veterinary technician specialties in emergency and critical care. And I met you as you two are the host of a podcast called Vet Tech Cafe, and you invited me to be on a year ago and I just had the most lovely time.

Dave Cowan:
Yeah, it was great, we enjoyed talking to you.

Dr. Andy Roark:
It was really good. I felt very honored because it is very rare to have a veterinarian on the podcast-

Dave Cowan:
That’s true.

Dr. Andy Roark:
… As you guys-

Jeff Backus:
That’s true.

Dr. Andy Roark:
… Tend to talk to technicians, so that was quite an honor for me. But I enjoyed the conversation so much, I thought it’s been a year since I came and met with you guys. And so I wanted to talk a little bit about your podcast, I want to talk mostly about the veterinary technician space and culture and things like that.
And I want to talk about that because it was funny when we were here doing the soundcheck, getting ready for the podcast, our producer said, “so you guys you are techs, you work with techs, you also do the podcast, it’s like you guys are putting on the cape and going and doing the thing.” And I thought that was funny, but let me go ahead and just start this out, let’s talk a little bit about Vet Tech Cafe and what it is before we start to get into what it means for technicians. So what was the vision for your podcast when you got started?

Jeff Backus:
Honestly, Dave and I met when we were doing our specialty certification several years ago and we were at Ivex in-

Dave Cowan:
2019.

Jeff Backus:
… Twenty eight-

Dave Cowan:
2019.

Jeff Backus:
… 2019 in DC, we were sharing an Airbnb and we were just hanging out one night after lectures and we were both in the same like, do we want to keep doing this or do we want to get out of med headspace? We were both not in a great spot in veterinary medicine and then we started talking about this podcast, somehow the conversation shifted to that and got us really thinking about all the cool things and cool people we knew that were doing these cool things and that reinvigorated us. And we talked for a couple of hours and then the next day we were like, “so are we doing this?” And now almost four years later, here we are.

Dave Cowan:
And it was more about the fact that we were frustrated, we’re like, “is there something we could do that’s different?” Because all we knew was clinic work, because we worked on the floor for 20 some odd years and we were both frustrated in our jobs and frustrated with where our career was stuck and we said, “there’s got to be something else out there.” And it shifted to a talk about a podcast, I don’t exactly remember how we shifted to that, but we said, “there’s nothing really in the podcast space for technicians, there’s a lot for the field, there’s a lot for veterinarians, but nothing really specifically for us,” and we’re like, “we should probably do that.”

Dr. Andy Roark:
I love that you did it. I think there’s a lot of people out there doing really good stuff at this, specifically the thing I liked about the way you set it up, it’s what I started trying to do with here with the Cone of Shame, was there were people out there I wanted to talk to and give a platform to. And so it wasn’t that you guys set out, or at least not since I became aware of you, it wasn’t that you were like, “we want people to hear us,” it was more like, “we’d like to talk to these other people and learn from them.” And I just think that it’s almost like a service position in that way of trying to shine the light on what others are doing. I think you do that really well, I encourage people to take a look at your podcast and look at the episodes you have.
It’s fascinating to hear you talk about that, about how you met. And so now I get to talk to some of the most successful people in the world in either in our industry and the proportion of highly successful technicians that tell me, “I don’t want to do this anymore,” or that they went through that period, it’s enormous. It is usually after we turn the microphone off or whatever, they’ll be like, “God, I was so burned out two years ago, I was trying to get… Or they’ll be like, “I’m thinking about doing something different,” and it seems to be such a widespread problem of people just getting tired of the technician role and burning out.
I’ve also had people who have come to me and asked the same questions that you were asking each other, which is, “what else is there?” Or say, “I’m in my forties, I’m into my fifties, my body’s not holding up like it used to. I have this background, I have this experience, I may have this advanced training, but I don’t know if I can keep doing that.” Talk to me a little bit, so when I say that, do you think that your position of, do we want to get out of the industry, do you think that that’s common?

Dave Cowan:
Very common.

Jeff Backus:
Yeah, very common. When we started, I was living in New England, my wife had just graduated vet school, was doing a couple of internships in Rhode Island and I was working at Tufts University. And working in academia darn near broke me and I was ready to get out, I was ready to go pour beer to brewery, that was going to be my next step. And we were coming back home to California and we had started this podcast, which frankly for me, I have found so reinvigorating for this career, hearing from people that found their niche and found what they love to do and they’ve carved out a path and a career for themselves.
Because like Dave was just saying, we’re ECC techs, that’s what we’re boarded in and sure you can move around to other ERs or ICUs or maybe even move into different departments in the hospital, but you’re still in the hospital. It was a little bit of a narrow focus, but with all of these guests that we’ve talked to, and we have learned so much about so many things that we didn’t even know existed after 20 some years in the field. So it’s been really, really reinvigorating for my career especially.

Dr. Andy Roark:
Yeah.

Dave Cowan:
You don’t know this, but Jeff and I are both extreme introverts and when we said we’re going to start a podcast, my partner, she’s like, “the guy who doesn’t want to talk to anyone’s going to have a podcast?” I’m like, “yeah, this is different.” And the fact that we can do that and talk to these people and bring their stories to our listeners, that’s amazing because we’ve gotten feedback from a lot of people saying, “I want to try that, I want to do that,” and going down that path of saying, “I’m tired of doing this too, so what else can I do?” So I think a lot of our listeners listen to us because they want to figure out something different to do, which was the whole point of starting the thing, right?

Jeff Backus:
Yeah. And there really is a lot you can do as a veterinary technician, under the umbrella of veterinary medicine, there are a lot of roles and careers inside and outside of the clinic that are out there. I think now in 2023 with remote jobs, there’s more than there’s ever been, but a lot of us just don’t know how to find it or don’t know what those jobs are. And so talking to some of these people that figured it out and are doing it, it’s awesome to listen to, from my perspective.

Dr. Andy Roark:
Taking a step back from the path, which is looking at alternate ways to practice, if someone came to you now in the position that you were in when you started and they were like, “man, I’m thinking about getting out of the profession, just leaving vet med in general, I’m not sure if I want to, but really, that’s where I am.” Based on your experience and then also the hundreds of people that you’ve talked to, what kind of roadmap would you build for somebody like that? Give me a quick action step, give me a treatment plan for someone who’s there.
And again, you don’t exactly know what’s going to work and what’s going to be different, but if they came to you and said, “I need a treatment plan, what are the steps, things like that.” And so let’s start with headspace, is what I like to talk about, it’s just before we get into what would you do, just philosophically, what have you come to believe about when you’re ready to leave? Where would you try to get them in their head to look at the profession or look at the options? Would you be optimistic? Would you tell them, “no, this may be unavoidable?” What would you try to get them to visualize for themselves?

Dave Cowan:
Well, first thing is, do you want to be in this field? That’s my first question, figure out why did you get into this field in the beginning and then find out is that still true? And I’m going to refer back to something you told us when you were on the show, find out what you love to do and find ways to do more of it. If working on the floor is not what you want to do, figure out where you can go from there and figure out what it is that you like doing in this field and figure out ways to do more of it. And the other part is that, is this field isn’t for everyone, so if you’re two, three years in it and you’re burnt out already, maybe this isn’t the field for you. For Jeff and I-

Jeff Backus:
And that’s okay.

Dave Cowan:
… Yeah, that’s perfectly fine. Don’t stay in it if you’re going to be miserable because we’ve got plenty of miserable people in this field that we don’t-

Dr. Andy Roark:
We’ve got enough miserable people.

Dave Cowan:
… Yeah, we’ve got enough miserable people, we don’t need to add to it, and just figure out what you like to do and find ways to do that.

Dr. Andy Roark:
It’s fascinating to me that you just own it like, “this might not be the place for you.” I think that’s true, I love the candor in just saying that, why do you want to be here, I think that’s good.

Jeff Backus:
And I think on our side of the spectrum too, our schooling, if you go the traditional AVMA route, it’s only two years, yes, there’s some student debt associated with that, but there are so many assistants that come into the field that haven’t gone through the educational path. So I don’t feel like they have the burden of the undergrad and the four years of vet school and the level of debt associated with that. So it’s a little bit easier to exit if so desired.
But I think to Dave’s point is, you work in a clinic for a little while, maybe that becomes stagnant, maybe it doesn’t interest you any longer. Or sometimes people just get promoted to supervisory or managerial roles that they’re not thriving in that they don’t love just because they were the most senior person there and that’s taking away from their love of the job. And so it’s like Dave said, getting back to what drew you to it in the first place, it’s like if you want to be on the floor, just be on the floor and take yourself out of those other roles. Or if you don’t want to be on the floor anymore, then what about being on the floor that you like, and what kind of things can you do with that that are just no longer on the floor anymore?

Dr. Andy Roark:
There’s this narrative that the career path, especially for paraprofessionals, but even for doctors, but definitely for paraprofessionals, the career path is upward into management. And you’re like, “why would that be true necessarily?” The thing that makes you a great practitioner on the floor, that doesn’t prepare you to manage other people in my experience, and you said that this is what you wanted to do.
I think one of the biggest challenges for technicians, and it is also true for doctors, I think both are opening up now, but it used to be, it was a hard development ceiling at the clinic level of, well, you’re a new tech and now you’re an experienced tech, and-

Dave Cowan:
And that’s it.

Dr. Andy Roark:
… That’s the end of … yeah, that’s it, and next step, management.

Dave Cowan:
Congratulations, you made it.

Dr. Andy Roark:
You made it, exactly right. So first of all, actually let me pause here and just so say, because you’re both in emergency critical care, do you think emergency critical care is worse as far as people burning out or over a certain period of time they go, “I don’t want to do this?” I’ve always wondered if the lifestyle that’s usually associated with it, if that puts more stresses on people or if you disagree?

Jeff Backus:
I would say I agree, I think each individual facet, each specialty deals with its own things that make it more difficult than others in certain areas. But I will say for emergency and ICU, the off hours, I will say I did overnights exclusively for 15 years and the toll it takes is not worth the $2 an hour shift differential.
But also, I think the level of the cases and the frequent interaction with futile care and just cases that we know are not going to end well and still pouring everything that we’ve got and such a high volume of those cases, I think it takes a little bit more toll. That being said, for internal medicine techs, I imagine the chronicity of some of those cases and just the slow linear progression takes the same kind of toll in a different way on them. And same thing too with general practice, I think it’s much the same, it’s just in a little bit different way.

Dave Cowan:
Yeah, I’ve worked in general practice and I’ve worked in emergency, and when I made that switch to emergency, I looked back at some of my colleagues that were still in general practice and the things that they were complaining about, for a lack of a better term, I’m like, “I don’t even care about that stuff anymore, it’s just a different mindset in emergency.” So like Jeff said, there’s stresses on every department of this field that I think sometimes people go to ER because they like the chaos, they like constantly having stuff to do and constantly be moving and the critical nature of it.
But other people like the, I don’t want to say relaxed, that’s probably not the right term, but the more steady pace or scheduled thing of working in general practice, where Jeff and I enjoy the ones where we have to think about things and use our brains and be active in the treatment of these cases. But I think every department in this field has its own stressors that are pushing people out of the field really.

Dr. Andy Roark:
Coming up on November the 14th with my good friend Dr. Emily Tincher, she’s been on the podcast a number of times, I love having her here, she is such a fun, interesting person who’s a deep thinker. And so anyway, she is doing a webinar called Clinical Empathy: The Exam Room Skill That Can Transform Your Team. I’ve had Emily on the podcast before talking about Clinical Empathy, this is a really good skill building webinar, this is great for your support staff as well as your doctors, but your team leads especially, but your technicians, your assistants, your CSRs, all of this is just is such a great communication content, I think you’re going to really like it. So anyway, that is on November the 14th, it is at 3:00 PM eastern noon Pacific.
And then the last one in the series is on December 13th, it is with Dr. Simon Platt, it is called, Head Cases: A Spectrum of Care Approach to Neurology in General Practice. So if you’re a neurology buff, if you like seizures, not like seizures, if you like knowing about seizures, if you like neurophysical exam tips, tricks and hacks, things like that, this is going to be a great webinar. So again, this is on December 13th, it’s at 1:00 PM Eastern, that’s 10:00 AM Pacific Time. Gang, I would love to see there, the links to all this stuff are in the show notes, go ahead and grab a spot, I’ll see you there. Let’s get back into this episode.
Well, going back to our treatment plan for I’m not sure I want to do this anymore, so we talked a bit about headspace, recognize why you want to be here, I think that’s great remembering your why point. Let’s move into other action steps, so once you come to that place and you are sure you do the reflection, and I talk to a lot of people who say, “I do really love it, I’m just unhappy, Verizon Wireless is not calling out to me, I’m not purpose driven to be a cell phone salesperson, but the benefits are not bad and it’s close to my house and I’m honestly thinking about going there.” So help me start to walk towards understanding what my options are.

Dave Cowan:
Well, as the three of us know, this is a very small field, everybody knows somebody. If there’s something that you want to do, there’s probably somebody you know or somebody that you are in direct contact with that has experience in that department or the field, you just have to talk to people, you have to network. And we talk about this on the podcast a lot, is that when we first started out, social media was not a thing, and now social media is very wide and it’s got its pros and cons. But one of the pros is that we can network with people that we would never have contact with years ago, there’s ways to find those career opportunities just by scrolling through social media.

Dr. Andy Roark:
Yeah, I think that’s a great point.

Jeff Backus:
And I think too, in some ways in this field, a lot of times we have almost an adversarial relationship with our management team and depending on what that structure is. But I think if you are seriously contemplating leaving your clinic or changing jobs or whatever it is, I think an honest conversation with management and actually involving them is really important because just don’t look at it as just their manager and you’re going to get fired or whatever, but they might actually be a resource to help network like Dave’s talked.
I would hope that that person actually wants to see you succeed, and maybe that’s not always the case, but they might have suggestions for you or this conversation of, “what do you like specifically about being here and your job here? Can we help do more of that and take away some of what you don’t like so that you feel more valued here or you start to enjoy your job more?” And again, I realize maybe that’s just rose colored glasses, but I think at some point, you have to have those conversations with the people that are responsible for the work that you do in your clinic because otherwise, it’s just going to be the same old thing.

Dr. Andy Roark:
I love these points, I think this is excellent. So I started thinking about thinking about this, so I want to start with David’s point, but, boy, 20 years ago, the idea of technicians networking was just dumb. And I would say that to people and they would just look at me like, what are you talking about? I think Jeff’s point of social media coming up is a huge one, it’s been particularly huge for technicians because there are so many groups of technicians online, things like that. None of that stuff used to exist, all the practices were very siloed and the practices would even try to keep the techs away from other techs because you didn’t want them to jump ship and-

Jeff Backus:
You didn’t want them to compare notes.

Dr. Andy Roark:
… You didn’t want them to compare notes, you didn’t want them to jump ship and go to the place down the road. And so you’re like, “you know what, I keep my people here and their people can be over there.” That’s an old school mentality that has nicely gone away, but I think social media opened up a lot for that. And there’s been so many technicians like yourself who have said things like, “you should go to CE.” And again, that’s another massive opportunity that just wasn’t there that long ago, there just wasn’t a lot of tech CE and now there’s so many more options, so I really do love that.
To Jeff’s point about talking to management, there’s two pieces to it, the first is, I’m a big believer in Brene Brown’s saying that, “clear as kind.” Which is, if you’re seriously thinking about bailing, if you seriously think, I can’t keep doing this, is it kind to the place that you work to not say anything until you’re totally toast and then just to give them your two weeks notice and be gone? Is it kind to go get another job and being like, “all right, well, I give my two weeks because I’m already set up there.” That’s not kind, kind is saying, “I just want you to know where I’m at and this is what I’m starting to feel and I’m looking for some opportunities to do some different things, try to maybe get to do more of the things that I’m really excited about, or I’m wondering if you guys have ideas for advancement for me or what my career development might look like.”
And savvy leaders, they’ll make something, I’ve done that with my people a number of times as they come and they’re like, “look, this is what I’m looking for,” and I go, “well, I don’t want this person to leave, let’s figure out how to create some opportunities for them to see if we can keep them here.” And then going originally back to the candor of like maybe this isn’t the right place for you, I wrote an article, it’s probably been over a year ago, but it was called Fare Thee Truly Well, and this is from the other side, is from the management leadership side.
But I don’t think a lot of people can do this, but I have met more and more people who said, “I hire these people and I want to train them and I want to grow them, and I do that in the full knowledge that they might outgrow my practice. They might come along and get skills and knowledge and grow until there’s really not much else here for them to do and they’re going to go somewhere else. And rather than resent that, rather than try to not let that happen, I’m just going to accept that that is going to happen, I’m going to continue to grow and develop people because it’s morally right and teaching is what I love to do and I’m going to believe that karma is out there and that good things will come back to me from growing people and even facilitating them going on to the next adventure.”
But I’ve met enough of those people over the years and people who have worked for those people and then gone on that really, when you start thinking about what’s important in life and the type of employer you want to be, I think that there’s a lot to that. But it’s not a mindset that comes naturally to people, people, they generally want to, if they have talented people that work for them, they want to keep those people and of course they do.

Jeff Backus:
And it’s very easy from that managerial perspective to become defensive and take it personally that this person is not happy in their role and they’re not being fulfilled. And so you have to lay down that armor a little bit and just be like, “look, we can do this, but let’s just have a couple of conversations and involve some other people here about this,” because probably that’s not the only person in the clinic that feels that way and it’s not going to be the only person down the road that feels that way and so got to find solutions.

Dr. Andy Roark:
I heard some terminology recently, someone told to me, I can’t remember where it comes from, but basically they were like, “there’s a couple of different types of really high-flyers in a business, there’s your superstars and there’s your rock stars. And your rock stars are people who are good at what they do and they like coming out and playing the song. And your superstars are the ones who, they are going somewhere, meaning that they’re doing new things, they are trying new things and they are soaring. And the superstars are great, they are self-driven, they know where they want to be, they want to grow. But the downside to superstars is they’re probably going to leave, they’re probably going to come and they’re going to leave.”
And I just thought it was really interesting the idea of just owning that to say and there are some people who are not interested in going on, they want to be very good at what they do and they want to remain challenged. And as long as they feel like they are good and they are challenged in their work and they do good jobs, they’re totally fine to punch the clock for 25 years and do it. And it’s not a bad thing, it’s not a knock, but for those people who are superstars and feel like, “I’m really internally driven, I want to keep trying new things, I get bored easily,” that can just be a different environment.
And so it was funny because the point of the article was, you want to have a mixture of rock stars and superstars, is you really don’t want everybody who’s gunning and trying to be a high-flyer like a couple of those people because they push everything forward. But it’s also really good to have people who are happy to be challenged in the way they were, so anyway, I thought that was really interesting.
What are your favorite resources for technicians? So obviously you guys have a podcast, it’s called Vet Tech Cafe, it’s an excellent podcast, as I said, I really like it, I really enjoy it, it is a lot of technician guests and talking to them about their careers and lessons that they learned and things like that. Are there other resources that you like for technicians?

Dave Cowan:
In terms of podcasting or-

Dr. Andy Roark:
No-

Dave Cowan:
… Just in general?

Dr. Andy Roark:
… I was more thinking, well, in terms of our action plan of trying to figure out where you want to go, what you want your career to be like. Just in general, if somebody said, “God, I’m feeling stagnant, not necessarily that I’m looking to go somewhere different or do something different, but I want something that’s going to make me not feel stagnant.”

Dave Cowan:
I would advocate for CE and it used to be a very commonplace thing where everyone had this CE allowance where they could go to conferences, they could go to different CE. And many years ago, one of the stipulations that I had with some of my CE was that if you’re going to go learn something, come back and teach it. And I really enjoyed that and I think that’s probably what got me on my path to enjoying teaching and enjoying doing CE and things like that.
But just going out and networking with other people and getting some continuing education, a lot of times you’ll go there and you may not learn anything new, but the experience of being there, like we have this post-conference invigoration always when we come back we’re like, “I learned this thing, we’re going to do this on our practice,” and we get back and a lot of times the people that we work with are like, “we’re not going to do that.” But if you come back invigorated and you can bring that to management and say, “we learned how to do this one little thing with these types of cases, can we try and incorporate that?” And I feel like people that get stuck and stagnant and burned out and leave is because they’re doing the same thing over and over and over again.
And back to Jeff’s point about finding other things to do in your practice, it’s a little bit more relevant to an ER referral practice because there are different departments. I feel like for me, the reason that I’ve stayed in this field so long is that I’ve done different things, I haven’t been doing the one thing for 25 years, I’ve been doing different things. And I feel like if you go to CE, you’ll learn about something and maybe that inspires you to try a different way or even move to a different department in your hospital to entertain your mind and make you more useful and get you thinking instead of just doing the same thing over and over again.
I feel like that’s one of the things that I would recommend for people, is to educate yourself, there’s a vast amount of knowledge and we are never going to learn all of it in this field and I think sometimes people don’t realize that, that there’s no limit to what we can learn here. And I found that the more that I educated myself, the more that I went to CE, the more invigorated I was to stay in the field.

Dr. Andy Roark:
I love it. Guys, I’m going to put links to the Vet Tech Cafe in the show notes, I’ll put a link to the episode that I did with you guys a year ago, if you want to hear us, flip it around and go the other way, they can check that out. Thank you both so much for being here, guys, thanks for tuning in and listening, take care of yourselves everybody.

And that is the episode, that’s what I got for you guys, I hope you enjoyed it. Thanks again to Dave and Jeff for coming on, gang, check out their podcast about Tech Cafe, I said I’ll put links into it down in the show notes. If you are enjoying this podcast, one of the nice things you can do is leave me an honest review wherever you get your podcast, it always means the world to me, it’s how people find the show, it’s super important, so like and share the episodes if you enjoy them. Guys, take care of yourselves out there, be well everybody, talk to you soon, bye.

Does Production-Based Pay Undermine Veterinary Team Well-Being?

September 28, 2023 by Andy Roark DVM MS

Dr. Ivan “Zak” Zakharenkov joins the show to talk about a recent article of his, and the wellness research he is doing in the veterinary industry. He and Dr. Andy Roark discuss the impacts of production-based compensation on wellness and well-being, and how veterinary teams might be compensated in a more satisfying way.

Cone Of Shame Veterinary Podcast · COS – 226 – Does Production – Based Pay Undermine Veterinary Team Well – Being?

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

LINKS

Article: Does Production Pay Undermine Veterinary Team Well-Being?

Galaxy Vets: An Employee-Owned Veterinary Group

Veterinary Innovation Podcast

Dr. Ivan Zak on LinkedIn

Book: Great Game of Business
(Links to Amazon.com are affiliate links and help support the show)

Dr. Andy Roark Resources

Dr. Andy Roark Exam Room Communication Tool Box Team Training Course

Dr. Andy Roark Charming the Angry Client Team Training Course

Dr. Andy Roark Swag

ABOUT OUR GUEST

Dr. Ivan “Zak” Zakharenkov is a veterinarian, entrepreneur, and advocate for the well-being of veterinary professionals. After graduating from the Atlantic Veterinary College, he worked in various settings across Canada, from emergency to general practice. Twelve years in veterinary medicine inspired Ivan to create Smart Flow, a workflow optimization system, and Veterinary Integration Solutions, a consultancy serving veterinary consolidators. In 2021, he founded Galaxy Vets, an employee-owned veterinary healthcare system that prioritizes burnout prevention. He holds an MBA degree from the University of Cumbria in international healthcare management. Ivan serves on the board of Galaxy Vets Foundation and co-hosts Veterinary Innovation Podcast and Consolidate That!

EPISODE TRANSCRIPT

Dr. Andy Roark:
Welcome everybody to The Cone of Shame Veterinary Podcast. I’m your host, Dr. Andy Roark. Guys, I’m here with the one and only Dr. Ivan Zak. Ivan is the CEO of Galaxy Vets, and he does a lot of things. He wears a lot of hats. He’s a practicing emergency vet. He’s a genuinely, deeply interesting guy. This is a sprawling conversation about, it starts off talking about compensation and production-based compensation and the impacts it has on wellness in vet medicine. And then we get into lots of different aspects of how vet medicine works and what are some of the underlying issues that we see with burnout, and is vet medicine really worse about burnout than other industries? And it all goes from there.
And so anyway, it is a really good, fun discussion. A lot to think about. I thoroughly enjoyed having Ivan on the podcast. Gang, I hope you’re going to enjoy this. Let’s get into it.

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

Dr. Andy Roark:
Welcome to the podcast, Dr. Ivan Zak, thanks for being here.

Dr. Ivan Zak:
Hey, and nice to be here. Thanks for having me.

Dr. Andy Roark:
Man, I am so psyched that you’re here. First of all, I thoroughly enjoy talking with you. You are just an interesting guy. You’re doing a ton of stuff. For those who do not know you, you are the CEO of Galaxy Vets. You were the creator of Smart Flow. You are a co-host of the Veterinary Innovation Podcast. You’re practicing, you do some emergency work, you’re still in practice. You got your hands in it. You’re just a genuinely interesting guy doing a lot of stuff. And so I was really happy to have you on because I saw something that you wrote on VIN. It was on the VIN News Service. And first of all, just stop and shout out to the VIN News Service. I love that team. They just do do great work, and they just put out really interesting stuff. So if you’re not reading VIN News, you’re missing out.
But anyway, you wrote an article called, Does Production Pay Undermine Veterinary Team Wellbeing? And this was something that I saw it immediately, it spoke to me. I think this is fascinating. So we talk a lot about compensation of veterinarians on this podcast and how the business of vet medicine happens. And so production based compensation is really common in our industry. And I actually just got an email from a veterinarian who’s not paid on ProSal or production based compensation, and they were like, “I feel like I should be. Do you agree?” And I thought, oh man, production-based compensation has become fairly ubiquitous in our industry. And I’ve always had some questions about it.
And let me be open and say I get paid on production when I work in the practice and I don’t seem to have problems with it, things like that. But I’ve always been a little wary of being like, yeah, paying doctors on production is the answer. It does not have drawbacks. It’s the way we should go. And so I saw your article and it really spoke to me. Let me just pause here for a second and say why, if you don’t mind, lay out your philosophy here as you start talking about production-based compensation as it interacts with team wellbeing.

Dr. Ivan Zak:
Yeah, so the topic is fairly early long standing with me too, because as a practicing veterinarian, I actually worked only my first year out of vet school on production because I saw the numbers. They said You could be on salary, you could be on production. And then they showed me numbers in three months and you would be an idiot not to start on production. I was making better money. And then the first year out, I think I was making more than anybody in my class. I jumped right into emerge. So that was good. But then because you’re an emergency and because I realized that when people are yelling in your face that you’re doing it only for money, then that was my, I was like, what if I was not, and I can prove it?
And then since then, after the first year, never worked on production. So I had my own thinking about it and it’s just an opinion. And you put three vets in the room, you’ll get four opinions as usual. So we tried to test that. I wanted to see actually statistically can we survey? And the third year in a row we’re doing this study where we are measuring the burnout and what we do in parallel with that, we give it a color and we say, okay, well what does burnout correlate? So one thing we do, we measure how burnout the industry is based on a sample size, usually about 2000 people.
And then with it, we had certain hypotheses that we throw in every year into a study. For example, what does compensation method do to burnout? What does the age do? What does the experience? What is the gender? And things that we want to know to better understand who’s the biggest risk, and then how can we manage hospitals, people, and everything to have less burnout? So that was the intent with which we studied it, and I wanted to prove myself right or wrong in my own hypothesis that production’s evil. So that was how we started.

Dr. Andy Roark:
Okay. You were a bit more to the point that I was, but yeah. All right. So the null hypothesis is production is evil. All right. Talk to me a little bit about, before we get into this, talk to me a little bit more about the burnout study. I have been watching this for years. I read it whenever it comes out. I’ve not talked to you about it in the past, but I have always watched it and I’ve always appreciated that you do it. It seems like good work. You do get a pretty good sample size. It’s across different roles in the vet profession, things like that. Talk to me about where your interest in burnout came from and just start to tell me the story of the previous years leading up to this one, if you don’t mind.

Dr. Ivan Zak:
So I got exposed to it through my personal experience and I’m fairly comfortable talking about it right now. But I personally almost lost my life through a suicide attempt. And essentially I didn’t know that. Now I know about myself back then and then I just thought, I hate my life now. I understand that more than myself. People hate life and a lot of them are veterinarians. And I’m comfortable because I think that we should talk about these things, especially if we get through it and then we are trying to analyze it.
So when I pivoted in my career career, we built Smart Flow, I love our profession. And at the time when it happened, I hated it. So then when I had a choice in what am I going to do next? And I was going through MBA and I chose as my thesis for the dissertation to research burnout, I wanted to find out is it systematic? Is it actually a problem in the industry? And if it is there a solution for it? And I wasn’t looking for a solution in medical or mental or anything like that. I was thinking that there’s probably a management problem to it. I think we’re driving people insane and then is there something that we can do better by managing people and prevent burnout through that? You should do yoga, you should meditate, you should work in flow that we talked about before recording. All of those things, but can we manage people better?
So I made it my career choice now in the next hopefully five, 10 years to focus on understanding how can we manage organizations better to prevent burnout. And that’s why this study became the research portion of my dissertation. And I’ve been repeating it since then. This is the third year that we came up with it.

Dr. Andy Roark:
Yeah. First of all, I love that and I think you’re spot on when I talk about burnout and preventing burnout, to me, I don’t like when I hear this idea that self-care is the answer to burnout. Because what you’re doing then is you’re acting like the person, the individual on the floor in the clinic, they have the power to take care of themselves and there’s no obligation of the practice that they’re in to not burn their people out. And I go, look, let’s be honest, it’s a division of labor here. It’s one, I have responsibility to take care of myself and to rest and recharge, and my practice has a responsibility to not throw me to the wolves every day and push and not let me take breaks or make me feel bad for taking breaks and things like that. I think about in two levels there’s the individual level and there’s a practice level when we start talking about this.
So listen, I’ve always enjoyed that you do this. I also, I a hundred percent with you on telling the stories of burnout and depression and things like that is just, I went through a period of burnout. It’s been about four years ago and I burned out pretty bad. And the thing that bothered me the most at the time was that I didn’t know anyone who had really burned out and then come back and seemed to be having a good time later on. And it felt like the end for me. And so I’m like, I did it. I would not recommend it. If you’re like, “I’m thinking about burning out,” I’d be like, “You should do yoga instead. Go on vacate, do something else, pick something different.” But if you do decide to burn out, just know that you can work through it. And honestly, you can have the best days ever on the other side.
So anyway, I love that you did that. Let’s start to talk about your findings on compensation in wellbeing. So will you break that down for me?

Dr. Ivan Zak:
Yeah. So the hypothesis, every research, our first research that we’ve done for my actual dissertation was we wanted just to measure it and then understand, is it because I thought maybe it’s like a shark attack, someone is killed by a shark and everybody’s like, “Oh my god.” But no truly we’re burnout. We determined in the first year, but then in parallel we just ask random questions like, what’s your age? What’s your gender? Do you work in corporate setting? I thought that corporate is evil, so therefore they probably burn out people more. Turned out that they’re actually not true, which-

Dr. Andy Roark:
Okay, I believe that. Yeah.

Dr. Ivan Zak:
Yeah. So that was proven wrong. So then we thought, oh cool. So we have a standard measurement of burnout. There’s a standard thing that we use, it’s called professional fulfillment. And this is just 16 questions, but it gives you this temperature gauge. And then in parallel we’ll throw in questions that we’ll read the stats and say, okay, people that are over 40, they’re less burned out than those that are under 40. And then women are more burnout than men. So there’s things that we started to look for last year. I was interested is goal setting in your career and life affecting your burnout status, which it does if you don’t have goal setting.
And this year I was wondering, okay, the evil production that I thought it was, is it actually evil in terms of burnout? Does it contribute to burnout? And that was one of the three things that we tested this year. And we’ve proven myself almost wrong. So essentially it was the reverse, which was shocking to me because there’s multiple studies in human health where it clearly says that production actually does cause burnout. So that’s an interesting finding.

Dr. Andy Roark:
All right, so talk to me about this. So what you’re saying is in the studies that you’re doing, you found that production was anti burnout related. Do you feel like being salaried is more likely to lead to a path to burnout? Tell me about that.

Dr. Ivan Zak:
So not necessarily in that direct correlation. It wasn’t like, oh, stop being on salary and you’re fine. You can’t apply it as a treatment. But the point is that what we found out, people that have less financial security and certainty in the future are more burned-out, which logical, but we wanted statistically to prove that. But then the second comparison of data showed that people that are on commission feel like they have better financial security. So it was not a direct, but it was an inference through this people that are on commission or production, they feel like they’re more secure in their financial future or retirement planning. And it turned out that those people are less burned out. So it didn’t show that it directly causes the burnout, which I was surprised. It could have proven my 20-year hypothesis being wrong. But that’s why you do the research to prove yourself wrong.

Dr. Andy Roark:
No, that makes sense to me.
Hey guys, I just want to let you know real quick, I got something really big coming down the pipes that is super fun. It’s not a workshop, it’s not a webinar, it’s not a live event, it’s not a summit, it’s not a program. It is something that is just going to be a ton of fun. And some of you have already found the path to learn more about it. I’m not going to tell you what it is here, I’m just going to tell you it’s great and it’s coming. And if you want to look around a little bit, you might be able to find the path to learn more. And so some of you already have, some of you have not.
If you’re like, “I don’t know what he’s talking about.” [inaudible 00:12:53] don’t know if you like puzzles, if you like trivia, trying to figure things out, find the root of questions. It might be worth poking around DrandyRoark.com. Definitely the newsletters, if you get the newsletters, there’s fun stuff there. But if you like figuring things out, it might be time just to poke around a little bit. We got some fun stuff going on. That’s all I’m going to say. I’m just going to leave you with that, guys. As you were. Enjoy the rest of the podcast. I’ll have some more news for you sometime soon.
So I like [inaudible 00:13:26]. Do you think the idea basically is that if you’re paid on production, then you feel like you have more control of your situation as you summarize it that way?

Dr. Ivan Zak:
I think that’s one of those things. But if I correlate it to burnout, because burnout has a lot of people only talk about burnout. They really imagine it’s like working too much. I work in a facility right now, I do a couple shifts a week in ER for fun. And I have clear understanding that people are burned out in it, but they don’t have a full workload. This hospital is not loaded enough with the patients, it’s a new startup, and they have all other things that organizations can do wrong to actually cause the burnout, such as there’s lack of control, they feel like they’re top-down managed, there’s complete disconnects of values. So that’s the second one.
These are defined in 1986 by Christina Maslach who researched burnout in organizational behavior. So these are the actual triggers. So lack of control, conflict of values, insufficient reward not only in monetary because they actually compensated well, but not enough thank you and just basic gratitude, unfairness, favoritism people on the same sort of level getting different pay rate with no explanation. And community breakdown, which means that we don’t know how to give feedback to each other and we don’t know how to resolve conflict, which is systemic.
So it’s not about working too much, it’s about other things that can happen with it. So I think that when we talk about people on compensation or not compensation, I think we need to look at the big picture of how people are working. Because let’s say I’m on production and it seems like I’ll have less burnout, but what I’m doing, I’m driving the entire team crazy and I’m just go, go, go, go, go because I am chasing the dollar. I want to be a productive, but what techs get per hour while I’m burning them out? And they’re actually more burned-out than vets usually. So I’m actually creating the environment in which techs assistants and receptionists are running crazy without compensating more. So the question of compensation of the organization is bigger than just one individual as a vet, but how do you compensate the team and align the incentives so everybody’s rowing in the same direction?

Dr. Andy Roark:
Is it possible to see that? Is it possible to look at the support staff who work with doctors paid on compensation versus support staff who work with salary doctors?

Dr. Ivan Zak:
So we are trying this, so we just launched it two months, actually two quarters ago, and we launched this and it’s very interesting. So there’s a book called Great Game of Business. It’s the whole methodology. And what they recommend is creating this bonus structure in which essentially what vets don’t do as business people, they don’t set the budget. That’s just, corporations do that. Individual vets, they never say, “This is my budget.” Because when we hear budget, we always think that budget is how much I can spend. This is not in the budget. You can’t buy an extra chair, you can’t buy another anesthetic monitor or whatever. But also budget is how much I’m planning to earn.
So what we’ve done in our bonus design, we said, okay, our plan and we reporting to investors is to be in this budget, you need to hit this number in June, this number is July, this number in August. If we all as a team hit the number above that, anything in surplus will be split between the teams as a bonus. The bonus is not in January, here is Christmas bonus for no reason. It’s not a gift. The reward with a very clearly articulated goal.
So essentially I think, and this is my new hypothesis, is that this way if the doctors on the production driving the team and driving everybody, but then the team knows is if they help this doctor to produce and they hit it above the budget that we clearly identified for them, we show it actually in the app. We have an app that all our employees have. They know how much they make per day in the clinic. It’s open book management and they’re trying to hit it above the waterline that we set. And if they do in the end of the quarter, each quarter they get a little check that represents the bonus.

Dr. Andy Roark:
Yeah, I like it. I always like it. So I’m a big fan of positive reinforcement and like you said, giving positive reinforcement when it’s a clear link to the behavior that we’re reinforcing and you’re like, this is what it is and this is what you did and this is when you’re successful and here’s how we’re being rewarded. That’s always spoken to me. Talk to me a little bit more about we have a problem with feedback and conflict resolution. You said that’s systemic. What do you mean when you say that?

Dr. Ivan Zak:
Well, we had a really interesting conversation today in our podcast about in general how we communicate in veterinary domain. So I can’t quote the study and I know that it floated through my desk one day, but apparently vet industry is the lowest EQ that you can find profession. People that want to work with animals and not talk to people, everybody says that. And then we’re just not trained through either we’re in tech school, whether we’re trained for animal attendant or veterinarian, there’s very little on how to talk to each other. There’s how to talk to clients. There’s how to articulate diagnosis in more simple terms. Now it’s there in schools, there’s never, how do you become a leader? How do you become a communicator? How do you provide and take, which is very important feedback, and then how do you resolve the conflict?
So I think that those are the huge, huge deficiencies. And whenever we go into a new team, so when we acquire practice, we go in and we understand, do people know that? And it’s just a baseline. It’s the basic training where you type people. I hate saying it like that, where you’re typing people, but you do the disc, you understand what they are so you can communicate with each other and understand that person like me would never talk to someone analytical and solve something on the spot. They’ll need a day to think about it. And then also, how do you resolve things? How do you don’t become passive-aggressive? All of these things, I think we just don’t have it. It’s just not in the curriculum wherever we come from. And I think it is pretty chronic in the industry.

Dr. Andy Roark:
That does make some sense. If you had your magic wand, and so you’re looking at this and you’re looking at the data, not just this year’s wellness study, but previous year’s wellness studies and we’re talking about feedback and we’re talking about resolving conflict and things. How do you fix this profession in the next five years? You got magic wand power, you could make some changes. What would you do?

Dr. Ivan Zak:
Yeah, that’s a good question. That’s a million dollar multimillion dollar question.

Dr. Andy Roark:
Oh, sure.

Dr. Ivan Zak:
I think if you let people solve their problems and the place where they work themselves, that’s the main thing. Stop being a manager who decides for the people that do the job how to do their job. If you can just give them the autonomy to decide that I have a problem X, but you need to give them power and say you are responsible and accountable. And then that leads to the compensation through the proper compensation structure that by fixing these problems and becoming more productive and efficient, you’re rewarded at the end as the business owner or just someone who receives bonuses is there as well. I think if we can allow all of our people, techs, vets solve things and the management would just support and create a system of idea generation and putting them into practice, I think that would be the best way.

Dr. Andy Roark:
I have this theory that veterinary medicine, I don’t have a survey to back it up, but I have this theory that veterinary medicine, I think we’re disproportionately perfectionistic. I think that there is a perfectionistic tendency in veterinary medicine. I think there’s a lot of people who want to get things right. I think we select for that tendency in veterinary schools and our education and things like that. And my thesis goes, if you buy into the idea that veterinary medicine as a whole is more perfectionist than other industries, I think that this is the number one reason that we struggle to delegate effectively is because there’s a right way to do it, and we know what the answer is, and we want to give the answer.
And in order to delegate effectively and empower people, just like you’re saying, Ivan, I’m a huge believer in this, take people the problem and let them come up with their own solution. But I feel like people struggle so much to do that because they want to say, “This is the answer, now do the answer.” And that just, it’s hard to get traction. Do you buy into any of that? Do you buy into the perfectionistic part? Do you think that that’s a barrier to letting people be empowered to fix problems on their own?

Dr. Ivan Zak:
A hundred percent. And I think that this is a huge part of our burnout problem because it’s almost like we’re in the veterinary podcast, so it’s almost like we’re breeding and selecting the breed with a certain traits for intelligence, solution orientation, everything else. But in parallel, we get this perfection. And perfectionism actually is not a good thing. People that are proud and saying, “I’m perfectionist,” it’s a form of fear. You’re afraid to make a mistake. So if you look at it from that angle and thinking that you’re proud of being perfectionist, that’s not a good thing. That means that you’re afraid to make a mistake and try something new. So I think that you’re absolutely right. We’re selecting people with a certain traits and it drags behind it, the burnout, people that are more susceptible to it and all other things.

Dr. Andy Roark:
No, I love that you say that way. It’s funny, the paradox that I put together is our selection criteria is very much pro perfectionism, right? Because you take that test by yourself, there is no delegating. It is you, yourself, self-improvement is painful because you’re both the hammer and the chisel or you’re both to stone in the chisel. And it’s sort of the same thing as people who excel in the academic part and get into vet school and do well in vet school are often that driven perfectionistic personality. But then if you want to become a high performing veterinarian, you want to build a really good, positive workplace, that’s antithetical to that mentality. It has to be the doctors that really perform there are a little bit more loosey goosey.
They’re a little more willing to let other people do things and say, “The team is excited about this. It’s not exactly what I would do, but I think it’s positive. I think my idea is better, but it’s not the one they’re excited about. So I’m just going to go along and be supportive of them.” I think that that’s one of the weird pain points that we have is what gets you a degree is not necessarily what’s going to make you happy and maximally successful afterwards.
Anyway, Ivan, thanks so much for being here. Thanks so much for talking with me. You’ve got a lot of irons in the fire. Do you want to talk real quickly about where people can find you? Where can they learn more about Galaxy Vets? Where can they hear the Veterinary Innovation Podcast? Tell me about all you got going on where people can keep up with you.

Dr. Ivan Zak:
Yeah, well, thanks for inviting me first, and then that was a great conversation.I do recommend, suggest subscribing to Veteran Innovation podcast, which you can find@veteraninnovationpodcast.com. There’s a great conversation always about innovation, so sign up for that. That’s a cool one as well. And then Galaxy Vets is just the project we’re trying to implement all of these anti burnout practices and management. So all the research that we do, it’s incorporated into building this organization that is owned by veterinarians and employee ownership is incorporated into it. And that one is at galaxyvets.com. So either one, you can find us there or on LinkedIn if you can spell my full last name, but I’m not going to do it here.

Dr. Andy Roark:
I’ll put links in the show notes to all that stuff. Guys, I’m going to link to the Great Game of Business, the book that Ivan mentioned earlier. So I’ll put a link to that in the show notes. Guys, thanks so much for being here. Thanks for listening. Take care of yourselves, everybody. I’ll see you later.

Dr. Ivan Zak:
Thanks, Andy.

Dr. Andy Roark:
And that’s what I got for you guys. I hope you enjoyed it. Thanks, doctor Ivan Zak for being here. Man, he was great. I’m going to have him back on the podcast. I just really enjoyed this conversation. I think I’d like to talk to him more often. So anyway, I thought it’s super fun. I love these idea type conversations. I hope you guys enjoyed them as well. If you did, do me a favor and write me an honest review wherever you get your podcast, share the podcast with your friends. That’s really nice thing that you can do. Anyway, guys, take care of yourselves. Be well. Talk to you later. Bye.

No, This Meeting Could Not Have Been An Email

September 27, 2023 by Andy Roark DVM MS

Every now and then, I like to hike my pants up to my nipples, slap a frown on my face, and shake my fist at kids in my yard. That’s what’s happening right now.

You know how it’s become popular for people to kvetch about work gatherings and say “That meeting could have been an email”? Well, on behalf of managers and leaders everywhere, I just want to say… “No. That meeting could not have been an email… because people don’t read their email.”

Sure, it makes total sense that if information needs to be distributed without conversation, bringing everyone together in person to do that seems wasteful and inconvenient. I felt this sentiment strongly for years… until I was the person who really needed to get his team on the same page.

Once I started being responsible for everyone working together and understanding what was going on, I learned an important lesson: Many people do not read and process work emails. And when I say “many,” I mean “enough to make it necessary to have a lot of in-person meetings.”

I don’t want to come off as overly aggressive here (I say as I try to spray kids on bicycles with my garden hose). People are busy and swamped with email. We have all developed the habit of skimming communications just to keep our heads above water. It’s not that we are lazy or don’t care. It’s just that we are inundated with communication. And for those who DO read their emails, it isn’t fair to have to sit through meetings where they already know all the information.

My hope in making this rant is 2-fold. First, I hope it will make people pause and consider how challenging it can be for leaders to keep their teams informed and on the same page before loudly complaining that the meeting someone worked hard on is a total waste of time. Second, I hope it will serve as a grumpy-old-man-style reminder to all of us to please read our work emails (and not to roll our eyes when managers continually beg the team to do so).

Now, for anyone who wants to stick around, I’m going to sit in my rocking chair and ramble about the good ole’ days until dinner time at 4:30pm.

Employment Negotiations Without Burning Bridges

September 7, 2023 by Andy Roark DVM MS

Stacy Pursell, founder of the Vet Recruiter, joins Dr. Andy Roark to talk about common pitfalls in negotiating for a new job.

Cone Of Shame Veterinary Podcast · COS – 221 – Employment Negotiations Without Burning Bridges

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

LINKS

The Vet Recruiter: https://thevetrecruiter.com/

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

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

Dr. Andy Roark Swag: drandyroark.com/shop

All Links: linktr.ee/DrAndyRoark

ABOUT OUR GUEST

Stacy Pursell is an executive search consultant or executive recruiter serving the Animal Health industry and Veterinary profession for 25+ years. She is a workplace/workforce expert and a Certified Employee Retention Specialist. She is hired by the world’s leading Animal Health and Veterinary employers to find top talent while at the same time helping Animal Health and Veterinary professional take the next strategic move in their career. Stacy is also the host of The People of Animal Health Podcast.

EPISODE TRANSCRIPT

Dr. Andy Roark:
Welcome everybody to the Cone of Shame Veterinary Podcast. I am your host, Dr. Andy Roark. Guys, I’m here with Stacy Pursell, The Vet Recruiter. Stacy has been a friend of mine for a long time. I don’t know that anybody in our profession has been involved in more hiring of employees than Stacy has. She is a recruiter, so she has worked for employers who are trying to hire new people, and she has also worked with people who are looking for jobs. As you can tell in this episode, she is a wealth of information. I really enjoy her. I love hearing her anecdotes about different people in their employment search and things like that.
Anyway, I want to talk to Stacy today because I have heard a lot of stories recently about job interviews gone bad. And what I mean by job interviews gone bad is not that the person didn’t get hired or didn’t choose to be there, but that bridges were burned or people left having hard feelings about how the interview went. And I thought about that and I asked Stacy and she said, “Oh, my gosh, you have no idea. Yes, it has never been as common as it is now for things to just absolutely burn down.”
And so anyway, I brought Stacy on to talk about how to avoid that. What should a job interview look like? And I took the position of someone who was seeking a job, but then I ended up switching sides at some point and asking questions about the employer. And it was just a fascinating conversation and she really played both sides very well.
And so, anyway, if you are thinking that you might be looking for a job, if you’re thinking you might be hiring somebody who’s looking for a job, if you know vet students that would be looking for a job in the future, this is a great episode just to hear. Because, man, it was full of little pearls and just really great reminders about how to be successful. So anyway, guys, that’s enough for me. Let’s get into this episode.

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

Dr. Andy Roark:
Welcome to the podcast, Stacy Pursell. How are you?

Stacy Pursell:
I’m doing great, Andy. How are you?

Dr. Andy Roark:
I am so great. It is so great to have you here. I enjoy you so much. I love when our paths cross and we get to talk. I have known you for a long time, probably since I was in vet school, I think, was when we met. But you are a dynamo. You do so many things. I enjoy your columns. You write for a number of different magazines and things like that. You are a speaker.
But the things that you’re mostly known for is you are the founder of The Vet Recruiter. You were the first executive search, I don’t know, service in vet medicine. Like I said, I don’t think anybody knows more about hiring and getting hired in our industry than you do. And so I always like to reach out to you when I have questions about employment and the process of getting jobs and hiring people. And so anyway, that’s how I know you, and that’s what I want to talk to you about today. Does that sound okay?

Stacy Pursell:
That sounds great. I’m so honored to be here. It makes me feel old though. What year were you in vet school?

Dr. Andy Roark:
I know, as soon as I said that I was like, “Oh, no, that’s not…” So 2008 is when I graduated from vet school. I can’t remember if I knew you in vet school or shortly thereafter. But you’re such a star in our industry and you’re so well known. It did not take long until I became aware of your writing and started to see you speak and things like that.

Stacy Pursell:
Well, you’re only as old as you feel and I feel like I’m about 30. So even though I’ve-

Dr. Andy Roark:
There you go.

Stacy Pursell:
… been doing this for 26 years, I wake up every day just loving what I do.

Dr. Andy Roark:
That’s so great. Oh, I love it. I absolutely love it. Okay, well, the reason I wanted to have you on today is this. So I’ve heard a number of stories that kind of feel the same to me. And what happens is, usually, I hear it from a practice manager or a medical director or something like that, and they’ll talk about interviewing a veterinarian or a paraprofessional for a job. And what they’ll say to me is, “This person came in and they had these unrealistic salary expectations. They came in and they wanted some amount of money or they wanted a benefit package that’s just, holy moly, astronomical.” And when I said that we’re nowhere close to that, they sort of said, “Well, that’s just sort of what it is.”
And what happens ultimately is these people don’t get hired and they leave a bad taste in the potential employer’s mouth. And I’m hearing this story, and I’m only hearing one side of the story. And I suspect that the person coming in has probably had conversations in the salary realm that they’re asking for or things like that, or they have reasons to believe that that is a worthwhile salary or a salary that is justifiable. And so I’m not getting to hear their side of it.
I do not think that these people are coming in… My impression is they’re probably not completely off base here. There’s just a radical difference in expectations. And so I think my interest is not what is the going salary rate? My interest very much is, if you are looking for a job and you’re interviewing, what are the best practices and what are the pitfalls we want to avoid when we go in and we’re going to advocate for ourselves? So we are going to negotiate and we are going to ask for the salary that we need to have or that we want to have.
And so we’re not going to be timid; however, we want to present ourselves professionally in a way that’s not going to have this kind of, the whole conversation melts down right on this point, and then there’s no back and forth, or the bridges are burned as we leave. So first of all, let me just ask, does that story resonate with you all at all?

Stacy Pursell:
It all makes sense. Yes. And that story resonates with me. We’re in unique times in veterinary medicine. I’ve been in the space, like I said, 26 years, and right now we’re having a supply and demand issue. There’s more demand for veterinarians than there is supply. So what that means is that, unfortunately, it causes some people to think that, “I’m in so much demand, I can behave any way I want, or I can ask for whatever it is that I want,” but they don’t think that the tables turn.
We’re not always going to be in the situation, in this type of economy, where we’re in a job seekers market, at some point the tables will turn. And so those things that people do now that are unprofessional, or if they burn bridges, that’ll come back to haunt them in the future.

Dr. Andy Roark:
Yeah, absolutely. So knowing that, let me go ahead and start to… Let’s just set the table here. So say that you’ve got, we can say a veterinarian, just to give an example to work with, we’ve got a veterinarian that you’re coaching and they’re going to go in and they’re going talk to a practice that’s interested in hiring a veterinarian. The salary area is just sort of opaque right now, we’ll say. We’ll say that they haven’t really gotten into that, but our veterinarian going in, they have salary expectations or they have needs, or they just want to put themselves in the strongest position possible. What kind of advice do you give them, Stacy, to set the table to have a productive conversation about salary with a potential employer?

Stacy Pursell:
Well, the first step I would say there, Andy, is not to lead with the salary. That should be the very last thing that should be discussed in an interview situation. So the number one piece of advice that I’d give that person is everything they do from the start to the finish of that process, number one, be professional, and number two, good communication skills.
I have countless stories about things people have done, especially in this market, that are unprofessional, could give you some stories we can laugh about today, and then poor communication skills. But salary should be the thing that should be discussed the very last, the very end of the interview process.

Dr. Andy Roark:
When you say good communication skills, everybody thinks they have good communication skills. The worst communicators are like, “No, I’m pretty solid.” What do you mean when you say good communication skills? So when you say, “Hey, have good communication skills,” and the wide-eyed veterinary looks at you and says, “How do I know? What are the good skills?” What specifically are you advocating for for people to follow?

Stacy Pursell:
Well, let’s talk about the bad first. So those that don’t have good communication skills, number one, they don’t communicate at all. They might think they’re communicating, but I call them a client, but from the candidate’s perspective, an employer, the employer is reaching out to them in whatever communication method, whether that be LinkedIn or a text message or email or phone call, and that person’s not responding. And then sometimes that employer is reaching out two and three times over days, weeks, and the person’s not getting back. And they might think that they’re responding. But from the employer’s perspective, if you’re a candidate interviewing, you want to respond that same day or at the very least within 24 hours. You don’t want to go days or weeks without responding.

Dr. Andy Roark:
Yeah. It’s amazing how much it means to people. But everybody wants to feel wanted. I feel like that’s really true is everybody wants to feel wanted. I have a 100% looked at different clinics that I was going to go work at, and I got the impression that one of them was like, “You need to be here. We want you to be here at our practice.” And that means a lot to feel like you’re important.
And so I could absolutely understand how somebody would say, “I’m really busy.” And I get messages, especially to things like LinkedIn. They go, “I’ll check it when I get a chance or I’ll get back to it,” and I get it. But that sort of sense of sending the message, “This is important to me and so I’m responding.” I think that that makes a lot of sense.

Stacy Pursell:
I’ve had candidates, Andy, that I sent a LinkedIn message to and two years later they’ll respond. And they’ll go, “I’m interested,” or, “I’m not interested.” And I go, “Well, it’s good you’re not interested, because that job was filled two years ago.” It’s like it took them two years to look at a message.

Dr. Andy Roark:
Oh, that’s funny. All right, so just be communicative and open coming in, and step one is be professional. All right, so we start to come in. And we like the idea of, obviously, coming into the salary last. Do people have concerns coming in? So what I’m looking at, I’m looking at new graduates from vet school are getting the highest salaries they’ve ever gotten. So I talked to a mutual friend of ours, Dr. Karen Felsted-

Stacy Pursell:
Yes.

Dr. Andy Roark:
… recently, and it’s funny she mentioned you on the podcast. But I was like, “Oh, I’m going to talk to Stacy very soon.” So it was great.

Stacy Pursell:
I love Karen Felsted.

Dr. Andy Roark:
She’s awesome. So she was saying that new graduates were getting salaries right now between a 100 and 150,000 for new graduates.

Stacy Pursell:
Yes.

Dr. Andy Roark:
And that’s got to be a shocking number for a lot of veterinarians who maybe haven’t been keeping up with the employment market. They’ve been head down, working shorthanded, trying to keep their head above water. And then a new graduate veterinarian comes in, and I’m not trying to make this just about a new graduates, but a new graduate veterinarian comes in and says, “I’m looking for $150,000 starting salary,” which is in that range. And I could see them absolutely seeing it as an opening bargaining position.
And I can also see that veterinarian employer just going, “We’re so far apart. There’s no way this is going to happen.” So given that, I guess my thought in this is just, are there things that can avoid us going through an extended song and dance and sort of courtship, if you will, only to find out at the very end that we are not in the same ballpark? Do you say, “No, you go through the whole process”? Or are there things where you can try to check that out earlier on? Just so we don’t spend… I would hate to go through a working interview and everything just to find out this was never going to happen.

Stacy Pursell:
Yes. So how I would answer that is, like I said before, salaries should be the last thing that should be discussed. And there’s a number of reasons why I’ll say that, which I’ll go into, but every new grad’s not getting 150,000.

Dr. Andy Roark:
Sure.

Stacy Pursell:
We’ve seen new grads get in the range of a 100 to 150,000. We’ve seen new grads get 150,000, but I would say the majority of them that I’ve seen in the last year are getting anywhere from a 100 to 135, with the average probably somewhere between 110 and 120. But I’ve had new grads turn down offers for 135 or 140 because they could get 150 offer somewhere.
But the problem with coming right out of the gate with the salary discussion is that you haven’t seen the whole package yet. And it’s like you’re using your leverage too early or you’re losing leverage in this situation. Because what’s happening is they don’t know how good you are. If you bring the compensation discussion up on the front end, they don’t know if they want to hire you, and they might have other candidates that they’re looking at too. And you’re interviewing with multiple practices, probably. The practice is interviewing multiple candidates. And at the end of the process, the practice is making a comparison between all of their options. You’re making a comparison between all of your options. And it really comes down to which position do you want.
Somebody could get paid the highest salary out there… What was that movie that Tom Cruise was in back in the ’80s or the ’90s where he goes to work for the mafia, and they offer him the highest salary and he is miserable and he is trying to figure out how to get out of there? Somebody might offer you the highest salary, but it might be a miserable situation. It might be a place where you don’t want to work.
So salary shouldn’t be the number one priority. It should be where am I going to fit in the best? What am I going to learn here? Where is this going to help me get to in my career? What are your goals? And those other factors. So I still say wait till the end to discuss salary.

Dr. Andy Roark:
Yeah, no, that absolutely makes sense.
Hey, guys, I just want to jump in real quick and let you know that my back to school webinar series is winding to a close. I’ve had a bunch of webinars on recently. They’re done by me. They’re done by guests of mine. I’ve got one more live one coming up. It is on Tuesday, September the 19th. That is at noon Eastern Time, 9:00 AM Pacific. It is a one-hour presentation. It has one hour of RACE CE. It is a presentation by me.
I will be getting the team on board with a spectrum of care approach. If you listen to the podcast very much, you know that I’m big on spectrum of care. I think it’s important to balance the quality of care that we put with affordability and accessibility to pet owners. This is about talking to the team about those concepts and getting everybody in the same place so we feel good about providing quality care and striving to meet pet owners where they are. So anyway, like I said, that’ll be one hour RACE CE. It’s me doing the presentation. Getting the team on board with a spectrum of care approach. It is Tuesday, September the 19th at noon Eastern Time. It is sponsored by Nationwide.
Also, I have got a webinar on demand for you. It is from Ceva Animal Health. It is called Updates in Canine Pancreatitis Treatment Innovation with Fuzapladib Sodium for Injection. If you haven’t seen this presentation before, it is a great presentation. It’s super, super action oriented on dealing with pancreatitis, and it talks all about the new drug on the market Panoquell-CA1. So anyway, that is on demand. You can watch that webinar right now. I’ll put links to all this in the show notes. Okay, let’s get back into this episode, but I hope to see you on the webinar on September the 19th. All right, bye.
So let’s say that we’ve gone through this, that this feels like a good fit that, yeah, it feels like a good fit. I can see myself in this practice. It seems like it’s got a good culture. I’ve got a couple of other offers out there, but I think this is a very potential hospital or high potential for me to fit in here and do well. How do job candidates open those conversations up? Or do they wait and allow the potential employer to open the conversation up?

Stacy Pursell:
So they should wait and let the employer bring the compensation discussion first? That’s always been my recommendation, based on my experience is let the employer bring it up first. Because at the end of the day, either the employer’s going to want you or they’re not. And anything that you do or say in the interview process in saying it too early could be a deterrent from getting an offer. Your goal when you go to interview for a position is to get an offer.
The first step is to get an offer. Once you get the offer, then you have leverage, because you’re the candidate of choice. So then if you don’t want to take the first offer that’s on the table, you can negotiate that offer. But if you don’t even get an offer because of something that you said and did early on, then you don’t have any leverage to negotiate. So first step, see if it’s a good fit. If the employer wants to hire you, because the candidate of choice, let them bring up compensation first. If they’re going to make you an offer, let them make you their best offer. And then if you want the position, negotiate.

Dr. Andy Roark:
Yeah. So you’ve played both sides of the table. And as a recruiter you have helped people get positions and then you have also helped employers find people who get positions. One of the sentiments that I hear a lot in practices is they’re optimistic about getting a veterinarian. And I heard something, I think it was Karen had mentioned something like the average veterinarian now seeking a job has something like 17 potential offers, or there’s 17 open jobs for every one veterinarian that’s looking for them. It’s ridiculous numbers.
And so I know a lot of practices that they’re working shorthanded, they dream about getting another doctor in just to help with the workload. And they feel like they’ve possibly found someone who would be a good fit, and they want it so much, and they’re terrified that they’re going to give an offer that’s going to be dismissed out of hand. And they say, “Well, this is kind of what I can offer and this is what we feel is a good offer that we can make, but we don’t want to get dismissed out of hand.”
How do you present an offer as the employer, Stacy? Are there ways that you put it forward so that you say, “This is what we think we can do?” Obviously, I want to turn this into a discussion, not into a, “This is what we have,” and the person goes, “No, I’m sorry.” How do I open that conversation up if the employer is the one who should bring the offer?

Stacy Pursell:
Yeah, I’m so glad you asked that question. And before I answer it, yesterday I was talking to my LinkedIn rep and she was showing me to a new analytics tool on LinkedIn. And we pulled up veterinarian jobs on there, and there are, it was like 10,352 or something, open veterinarian-

Dr. Andy Roark:
Wow.

Stacy Pursell:
… jobs on LinkedIn. That was just yesterday. And then the last time I checked the AVMA site, which was a few weeks back, it was close to 5,000. It was just under 5,000 open positions. And then one of my clients just today, she sent me an article, I haven’t had a chance to read it yet, but I skimmed it, and she was telling me what it was about. This article she sent me said, “It takes 16 months to hire a veterinarian on average in the US right now.” And so you’re an employer, you’ve got a candidate, you want to hire this person, you want to make an offer, what do you do?
Well, my recommendation is not just to make the offer that you’re thinking about right out of the gate, first ask the candidate what they want. Like you said, you’ve been on job interviews where you felt wanted. Everybody wants to feel that way. They want to feel this employer wants me. So the employer should express to that candidate, “We think you’d be a great fit here. We want to hire you. We’d love to make you an offer. But before I make you an offer, I’d love to know what offer would you accept?”

Dr. Andy Roark:
I like that.

Stacy Pursell:
“What would it take for you to come here? Let’s talk about that.” And then open up that discussion where the candidate can speak to that, and the candidate can let the employer know what it’ll take to get them hired.

Dr. Andy Roark:
I like that. That’s really good wording. I very much like that. That’s letting them know that you’re interested and you would like to move forward, and then ask them about their expectations. I like it a lot. All right, great.
So this all feels like a good sort of setup here. We’ve got some good communication. It sounds like we’re sort of opening this up in sort of a low stakes setting to talk about what everybody wants to get out of it. I like that very much. When you are the job seeker and you’re starting to talk about what’s important to you, are there tips about communicating what you care about? Or are there pitfalls that you have seen where people really drop the ball or turn people off as they’re communicating what’s important to them? So let’s move on to this conversation.

Stacy Pursell:
So just the other day, there was a candidate that was going to talk to one of our clients and she was going to receive her offer. So the client had set up a Zoom call and the candidate was supposed to show up on the Zoom call to receive her offer. Well, the candidate failed to show up to receive her offer because she forgot.

Dr. Andy Roark:
Oh, no.

Stacy Pursell:
First step is show up for that conversation. Don’t forget. So a funny story that just happened in the last week is there was a candidate that showed up for a conversation in her pajamas sitting in her bed.

Dr. Andy Roark:
Wow. Really?

Stacy Pursell:
Really. A different candidate, not the one that didn’t show up. This one showed up for a conversation with the employer in her pajamas, sitting-

Dr. Andy Roark:
In her pajamas.

Stacy Pursell:
… in bed.

Dr. Andy Roark:
Yeah. It’s like, “I couldn’t get going a little any earlier. This is my nap time.”

Stacy Pursell:
It shows that it’s not that important, right?

Dr. Andy Roark:
Yeah.

Stacy Pursell:
Because if it was an-

Dr. Andy Roark:
It sends that message.

Stacy Pursell:
… important conversation, you’d get up, you’d get dressed, you’d not have your bed as your backdrop. And now I’ve forgotten the question.

Dr. Andy Roark:
Well, no, I was asking for tips, but you’re setting the bar real low, Stacy. You’re like, “Well, you should show up and wear clothes.” And I’m like, “Okay, check and check. I got those.” But, yeah, so starting to communicate what we’re looking for in the job in a way that continues that conversation, so best tips and tricks.

Stacy Pursell:
So the first step is do your research, from the candidate perspective. Do your research, go to sites like AVMA, salary.com, ask recruiters. Recruiters know what candidates are getting in the job market, so ask a trusted recruiter. If anybody wants salary data, we’ve got that. We can provide that here. But you want to do your research, so you know what’s reasonable. You want to get what you can get, but you don’t want to be greedy. So you don’t want to ask for things that are over-the-top, unreasonable, unrealistic.
Especially for a new grad, because new graduates coming out, they don’t have any experience yet. It’s their first position. It has to be a give and take. And any employment situation has to be a give and take. You’re probably not going to get everything that you want. So rank the things that you want in the order of priority, what’s most important to you? And then when the employer opens up that conversation, let them know, “This is what I would like.”
But remember that it is a give and take. You’re probably not going to get everything. Focus on what’s most important. And don’t keep coming back with one more thing, one more thing, one more thing. And I’ve seen candidates do this all the way at the point where they’ve accepted an offer, “Oh, by the way, can I have one more thing?” That comes across as being greedy.

Dr. Andy Roark:
Yeah, it makes you feel nickel and dimed. You know what I mean? If you had even presented it all at the beginning, that would’ve been different from the just sort of continuing to tag on little asks, on and on and on. Yeah, that makes a lot of sense.
Okay, so we’ve come into the conversation. We’re wearing clothes. We’re trying to lay out… I really like the idea of prioritizing what is important to you. I had a friend in vet school and time off was what she cared about. She was very flexible in salary, but she wanted at least three weeks off during the year, because travel was her thing. That was why she was working, so she could travel. And so she ended up taking a very modest salary, but she was off, I think, four weeks, something like that. Which our European listeners are like, “That’s normal.” It’s like in the states, not so much.

Stacy Pursell:
We just had a candidate last week that was going to interview with our client. So we were in the process of setting this veterinarian up for an interview and he went back to his current employer. I don’t know why people do this sometimes when they go back to their employer and tell them they’re interviewing. But he went back to his current employer and told him he was interviewing and they said, “What would it take to keep you?” And he said, “More paid time off.” They gave him two months of paid time off.

Dr. Andy Roark:
Wow.

Stacy Pursell:
And so he decided to stay and renew his contract there, and ended up not going to interview with our client.

Dr. Andy Roark:
Oh, wow. So, yeah, everybody’s got a thing. And so it just makes sense to know what do you really want? I think a lot of people, I’ve been thinking a lot about this recently in other contexts, but we all have this idea of what we should do or what applicants should do or what your employment contract should be. And none of that stuff really matters. It’s not about what it should be. It’s what do you need? Or what makes sense for you in the world? So I don’t know, do you agree with that?

Stacy Pursell:
Every situation is unique. We have clients that do this, I recommend it, it’s not a one size fits all package. So when you’re an employer and you’re hiring, don’t have a one size fits all package for every one of your employees. Find out what’s important to each one of them. For somebody, it might be a higher salary. For some person, they want to work on straight salary. Somebody else might want to work on ProSal. Somebody else might want more time off. Somebody else might want more continuing education. Somebody else might want to negotiate a new piece of equipment or new training. So find out what’s most important to that person. Try to cater to what they need and that’s going to help you retain that person longer.

Dr. Andy Roark:
That makes sense. All right, so coming to the end of the discussion here. So hopefully, we’ve had to go back and forth and everybody’s started to talk about what’s important to them in a way that doesn’t feel threatening or doesn’t make the other person feel judged. And so we’re coming to that conversation now. We’re sort of moving towards an agreement. Any words of advice on actually reaching an agreement?
We’ve talked about what’s important to me. We’ve talked about what’s important to the potential employer. Any advice that you can give on helping people actually get over the hump and come together and shake hands on the other side?

Stacy Pursell:
Yeah. So like I said, wait for the employer to bring up the discussion, let them know what you want, try to give it to them all at once, so you’re not doing the back and forth thing like we talked about. And then, I would say, don’t necessarily accept the first offer. There is usually some room to negotiate. But make sure that you’re getting the things that are the highest priority to you. And then if it’s not what you want, let them know that. If they’re not able to offer and you’ve got some other options, you don’t have to accept the offer. But if it’s a place that you want to work and you feel good about the offer, feel… I would say one thing too, don’t take too long to make a decision on the offer, because I have seen veterinary practices, they make someone an offer and they take two months to decide.
They’ll keep interviewing, and they’ll make other offers. And so if they extend the offer and you’re sitting on it, and then you decide… somebody else might take the offer, and then they might have to take it off the table. But once you get to the point where you feel good about it, and most of your concerns have been addressed and you feel like even though it’s not everything, it’s still a good offer and it’s the place you want to work, don’t turn down a good offer just because it’s not everything you want. Because it is a two-way street, you don’t want to appear greedy.

Dr. Andy Roark:
No, that totally makes sense. Stacy Pursell, thank you so much for being here and talking me through everything. This has been really awesome. I always love having you on the podcast. Where can people find you? Where can they learn more about you and The VET Recruiter?

Stacy Pursell:
So my website is www.thevetrecruiter.com. You can email me, my email address and phone number are on the website. I’m also on LinkedIn and my last name is P-U-R-S-E-L-L. Some people put a C in there, but it’s an S.

Dr. Andy Roark:
I could see that. Perfect. Well, thank you so much for being here. Gang, thanks for tuning in. I hope everybody enjoyed this. I’ll talk to you soon.

Stacy Pursell:
Thank you Andy.

Dr. Andy Roark:
And that’s it. That’s what I got. Thanks for being here guys. Thanks to Stacy Pursell, The VET Recruiter for sharing her knowledge. I enjoy her.
Anyway, gang, if you enjoyed the podcast, leave me an honest review wherever you get your podcasts, or share it with your friends. That’s how people find the show. I love making this stuff. I love it when people get something out of it. So help me find people who could benefit. Anyway, take care of yourselves. Be well. Talk to you soon. Bye.

How a Spectrum of Care Approach Can Improve Team Efficiency

August 17, 2023 by Andy Roark DVM MS

Dr. Emily Tincher returns to the podcast to discuss how to keep teams working efficiently while implementing a spectrum of care approach inside practices.

Cone Of Shame Veterinary Podcast · COS – 217 – How A Spectrum Of Care Approach Can Improve Team Efficiency

This episode is made possible ad-free by Nationwide.

LINKS

Embracing a Spectrum of Care: https://www.petinsurance.com/veterinarians/spectrum-of-care/

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

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

Dr. Andy Roark Swag: drandyroark.com/shop

All Links: linktr.ee/DrAndyRoark

ABOUT OUR GUEST

Dr. Emily Tincher is a collaborative and data-driven leader who advocates for a pet-parent centered approach to communication and medicine through spectrum of care approaches. She is a second-generation veterinarian and a 2016 Auburn University’s College of Veterinary Medicine graduate. Emily has practiced clinically in small animal emergency and general practice.

As the Senior Director of Veterinary Relations at Nationwide Pet, she oversees operations and strategy in the veterinary space, including industry relationships and outreach to veterinary students, veterinarians, and veterinary teams. Emily serves on the AVMA Early Career Development Committee and is President of the Board of Directors for the Veterinary Leadership Institute.

Outside of veterinary medicine, Emily enjoys traveling with her husband Kyle, competing with her horse (Blue) in the sport of Eventing, and endlessly spoiling her two perfect dogs (Tuxedo and Cricket) and rotten orange tabby (Exploding Poptart).

EPISODE TRANSCRIPT

Dr. Andy Roark:
Welcome everybody to the Cone of Shame Veterinary podcast. I am your host, Dr. Andy Roark. Guys, I am back with my good friend Dr. Emily Tincher. We are talking about spectrum of care making teams more efficient. People talk about, Hey, I understand the need for a spectrum of care. We want to keep care accessible. We want to make sure that we provide the best options for treatment given where different patterns are and that they have different experiences and they face different challenges. I get that. But how do we keep our teams working efficiently while being flexible in this way? And guys, that’s what we get into today. It’s a great episode. I hope you’ll enjoy it. Hope you get a lot out of it. Thanks to Nationwide for making this episode possible ad free. Guys, let’s get into this episode.

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

Dr. Andy Roark:
Welcome to the podcast, Dr. Emily Tincher. How are you?

Dr. Emily Tincher:
I’m great. Thanks so much for having me back, Andy.

Dr. Andy Roark:
Oh man, I always love our conversations. You’re so fun to talk to. For those who don’t know, you are the senior director of Pet Health at Nationwide. You and I have known each other for at least a dozen years now. You were involved in the Veterinary Business Management Association as a student, as was I. And we have been friends ever since you got into that program many years ago. And so now you are changing the world. You’re doing a lot of speaking on spectrum of care, which is something that I’m really excited about and access to care. So lot of my, if you listen to podcasts, I do talk a lot about access to care because it is something that’s important to me. So anyway, I love having you here. Thanks for coming on. How was everything going with you?

Dr. Emily Tincher:
It’s going great. I love talking about Spectrum of Care with you. I also love just listening in and learning from the podcast, especially around communications in the exam room, which I know we’re going to talk a little bit about today too. So fun.

Dr. Andy Roark:
Yeah, well you’re very kind. But yes, I do love that stuff. All right, well let’s get into a little bit because I want to jump in. So one of the things that I want to talk with you about today is general price increases in veterinary medicine. So I’ve seen, we’ve had guests on the podcast before and we’ve talked about generally we’re looking at numbers across the nation. Number of pet appointments is down a bit and prices per appointment has gone up. So we’re not seeing a decrease in revenue, we’re just seeing an increase in sort of appointment prices and stuff like that. And so I know at Nationwide you guys are getting claims, you’re seeing this. Does that kind of jive with what you are seeing as far as pricing in our profession?

Dr. Emily Tincher:
It does and we’re seeing that for a number of reasons and certainly our nationwide claims data where we process a lot of claims every year for over 1 million pets that are insured actively. But we also see that just looking across various data sources. So one of them is the consumer price index for example, which is way outside of veterinary medicine in what they monitor. But veterinary services are one of 200 categories that they look at. And we’ve seen the consumer price index for veterinary services was pretty significantly higher than the rest of the consumer price index for 2022, for example, prices went up by over 11% in that year, which is pretty significant.

Dr. Andy Roark:
What are the main drivers? What is pushing prices up? Are we doing different kinds of services? Is it just straight up increases in pricing technology? Is it labor, the main drivers of these price increases?

Dr. Emily Tincher:
A great question. I think it’s one that we again, have to look at multiple data sources to understand. And I think our partners at Source do a really awesome job trying to explain this and a lot of industry leaders that are looking at our workforce crisis for example. So how do we help to support both recruitment and also retention of our staff members? That’s a driver one of the reasons. But we also know, especially during covid, kind of the prices for pulling in the goods that we need to do our jobs every day. They changed, they went up a little bit more than we saw before the pandemic. And there are probably other things too. We have the way that we practice medicine has changed in the last 10 years, whether that’s adapting business models, whether that’s, and we can talk about things like stratification or really knowing, honing in on who your client is, which I think you’ve done a really awesome job and a lot of platforms just understanding the complexities for this, it can get hard quickly to think about.
It’s helpful for me to simplify it down to there are a lot of reasons why this is happening. Cost is increasing amongst other reasons that pet owners are feeling the change. But the result is pet owners are feeling that. And to your point about we’re not decreasing revenue, we’re actually increasing it in the vet profession, but we are decreasing in visits in the year of 2022 saw not just because of costs. I want to inappropriately correlate those, the 17% decrease in visits compared to a year over year compared to 2021, which is pretty significant as well.

Dr. Andy Roark:
Yeah, it is significant. When you think of 2021 was kind of post pandemic people coming back, you should think our visit count would be going up as opposed to down. Yeah. That bothers me when we start to look about it, when we start to look at it, I think everyone who’s been in vet medicine, whether they’re a technician or a doctor or even probably someone at the front desk has at some point felt a pinch where you feel like, I’m here because I want to help. That’s an important part to me. And when people say to me, I can’t afford this, or one of the reasons that we get asked for advice all the time I think is that people are like, I don’t want to go to the vet and have to pay this money. I think people are trying to figure out how to get around going into the vet kind of more and more.
And it bothers me because I don’t want to be the vet police who’s like, don’t not helping you need to go to the clinic. And at the same time I go and I can empathize with them and sort of say, I get it. Don’t, not easy to throw around a couple hundred bucks every time your pet throws up on the carpet. And so I get it, but we’ve all been kind of stuck there. I think that’s why a lot of us get frustrated when people say, I don’t understand why you won’t just give me advice on the phone or I don’t understand why, you know, told me to go into the clinic as opposed to just taking care of this here at our dinner party. Yeah. Anyway. Yeah, I feel like that’s a real pain point.

Dr. Emily Tincher:
It’s a pain point from multiple perspectives, again, from the pet family side of things. We know from a couple of reports that as little as 200 to $300 in an unexpected veterinary expense can be really stressful. And for a lot of families across the US, something greater than $500 can throw a pet family into debt, which is, I don’t think a lot of us would expect necessarily. But the data and the access to care coalitions report for example, says that about three quarters of middle income families still live paycheck to paycheck. And so things like the unexpected, especially for pets, it’s a little bit easier sometimes to plan for wellness. But the unexpected of, we got to figure out this vomiting dog on the carpet, we, it’s happened five times today. We’ve got to go figure this out and help the pet out. That gets really hard for people.
And so I think even bringing that into our staff and saying they also struggle with that. I know one of the questions that’s been rattling around in my head a lot since the Uncharted conference in April was our mutual friend, Dr. Adam Little, he asked a question in his session and it was his first question of talking about costs for pet owners. And he kind of flipped it on it its head and said, who do we agree with the statement across a range? And ask everybody to get up and move around and then have a conversation in the room. Do we agree or disagree with the statement that our staff should be able to afford the most expensive levels of care that we offer and at usually the most expensive correlating with the most advanced or gold standard level care? And it really started some really interesting conversations of we are us in vet med, we are the people that we serve sometimes.
And I know for me when I worked at a specialty hospital, I as a veterinarian couldn’t have afforded a lot of the estimates that I sometimes handed out. And so that brings us back a little bit to the idea of, okay, we know costs are rising, but we also know the level of care that we can offer is rising. Those things together really make these conversations around cost of care so uncomfortable. Especially if the care being offered isn’t something that the person talking about it that the technician in the exam room talking about it also couldn’t afford.

Dr. Andy Roark:
Oh yeah. Well there’s that credibility issue too. We talk about exam room communication stuff all the time and one of his credibility is to be able to say, if you don’t say it outwardly, the fact that I do this from my own pet lets me talk with an ease where I can sort of say, yeah, I walk my talk here. This is something I actually do it. It’s important psychologically, I have thought a lot about that over the years because what does it mean to say this is the standard that we believe is required to be a good pet owner? And your technicians are like, I can’t do that for all of my pets. And I know around now there are some technicians that have 37 pets and I’m like, well that’s a whole different thing. You can’t have Noah’s Ark and make me feel bad because Cause parasiticide are expensive.
Yeah. Where’s the car? Yeah, exactly right. No, it’s all shades of gray when you get into it. But I do really feel like at some fundamental level, I want the people working in the clinic to say, yeah, I do this stuff cause otherwise, you know, get this cognitive dissonance where you’re like, man, all day long. I tell people how important this is, but I don’t do it for my own pets, which either means that I’m lying to them or it means that I’m not a good pet owner or I’m not doing something that’s important. And that’s the mental trap that people get into it. It hurts people. And so that is, I’ve wrestled with that for a long time as cost of care continues to go up. And at the same time, you know, talked about the labor shortage and trying to keep people in even before the labor shortage, we have radically underpaid people in our profession for a long time. And there’s sort of this ethical wrestling for the steering wheel of what is the greater good? Is the greater good to extract revenue so that we can pay our people a higher salary? Or is it to not extract a higher pay point to is to keep care as priced as low as possible and to let our people let our eat people eat ramen noodles. And again, I think it’s easy to think that, and we’ve kind of wrestled over that. I like to believe that there are some solutions in the middle.

Dr. Emily Tincher:
I think there’s a lot to unpack in what you said there. So that idea of if our staff can’t access or the average pet owner is stressed by accessing the level of care that we’re offering, maybe an alternative. It comes back to that idea of, well, we don’t all have to want or access the same level of care. Sure. What does it look like to provide instead and recommend actively a spectrum of care to say we have a range of options across basic to advanced that we can tailor these solutions to whatever the pet family’s goals, values and resources of course, including finances. We’re talking about cost of care today. How do we tailor those conversations as efficiently as possible? And to your point about underpaying, I think especially our staff, our technical staff, how do we work so that we collaborate with them to let them work to the very best of their ability and then also compensate them appropriately for doing that.

Dr. Andy Roark:
Yeah, that’s kind of where I wanted to go with you today specifically. And so I, I’m really interested in this cause we’ve, you and I have talked a lot about running best practices for a long time and I think that we’re pretty much in alignment that vet medicine’s a team game and as a doctor and you’ve worked as emergency doctor for many years, leveraging your technicians is smart medicine, how we get things done. And so I want well leveraged texts, I want consistent communication. I want the pet owners to kind of get a plan and I don’t want them to feel like they got told one story and then fun. Andy shows up and tells them a different story, you know what I mean? And then people at the front desk tell ’em a third story. I really want us as communication to be on the same page.
And at the same time, I really like this idea of meeting people where they are and trying to talk about what the individual person’s needs are inside the context of what we do in our practice. And trying to say, okay, given what your needs are and given who our practice is and how we practice, what is the Venn diagram overlap there where we say, hi, your needs are getting met and our needs are getting met to feel good about the work that we’re doing and this works for everybody. And so how do I set myself up to take advantage of a well leveraged staff, consistent communication, things like that. And then also have this flexibility, try to meet people where they are and understand what’s happening. Can we start to talk about what that looks like in practice?

Dr. Emily Tincher:
Yeah, I think it might be helpful to break it down into two pieces a little bit. So let’s talk a little bit about leveraging the staff first, since we’re talking about kind of dollars and cents and pay paying our staff appropriately. Why don’t we start there? I think one of the things that we always really try and do here at Nationwide is not advocate for something that we don’t see an evidence base for. And so leaning on what do we know as far as research or case studies that we can lean on? And I think what’s really tricky when we start to talk about workforce is I, I’m sure we have some listeners now that are thinking it would be great to leverage technicians, but I can’t find none of them. None of them are available and I am desperate to hire or potentially even willing to pay for their training so that I can find them. So I hear you want to acknowledge that it is a challenge that we have to find license or credentialed technicians. The other challenge that we have though is retention of them in the field. And if we look at a study that Avta conducted, I think in 2016, a couple of years ago, they asked technicians, what’s the greatest reason that you leave the field of veterinary medicine? And are you familiar with that one? What kind of pops to the top of your mind of why they might leave?

Dr. Andy Roark:
Oh yeah. So there was not being able to work at the top of their skills I think was one or no developmental path. Wasn’t that one of the big ones career path, the pay was on there, of course

Dr. Emily Tincher:
Pay, yeah, of course on there. But it’s actually not number one. Number one is exactly what you said. First is utilization of their skills to the maximum amount and actually recognition, feeling like they’re seen and valued was in the top five too. So those very quickly all come together. So yes, we have a problem with we need more technicians, but we also need them to stay. And so I think part of what our conversation can be here is how do we say, okay, we understand those are some of the reasons you’re leaving. Let’s talk about how to get you to stay in a way that helps vet healthcare teams to be able to provide more care, to be able to hopefully be a little bit more efficient and have see a few more appointments, but also do so profitably. So I think that’s really interesting is there’s another JMA study from a couple of years ago that, and I think it’s a older one at 2010 or 12, we’ll find it for the show notes of if you have a credentialed technician, they can contribute, I think it’s like $93,000 a year to profitability in a general practice if they’re leveraged, well, pretty significant improvement in the value from a business owner, from business manager to have and to use those technicians as much as we possibly can.
We also, in our college program where we speak on behalf of nationwide to all of the vet schools across the us this last springs our partnership with the V B M A where we met one of our team members, Dr. Kristen Walker, built out a case study of, okay, what does it look like to not leverage technicians in a way that we probably have all seen? And so what she built out was looking at a really common problem, ear infections, and that’s always in the top five for the most frequent claims for us for dogs, top 10 for cats too, actually every year is ear infections. So we know it’s common. We know that general practices and me in emergency and urgent urgency, urgent care are seeing these. So this is a universal problem in companion animal medicine. So what are we typically doing for ear infection?

Dr. Andy Roark:
Yeah, right, so ear cytology, ear cleaning, yeah, yeah, no, nothing Crazy. Ear

Dr. Emily Tincher:
Medications, yeah, ear medications, ear cleaning, probably

Dr. Andy Roark:
Possibly a culture, but it depends on what we see and probably not,

Dr. Emily Tincher:
Probably not, but possibly we are, especially if it’s a chronic case, we might consider something like that. But minimally, most of the time, not always, but a lot of the time we’re going to do an ear cytology. Okay, great. So we’ve done an ear cytology. Who’s doing that in most cases in your experience?

Dr. Andy Roark:
Oh man, this is hard. So I’ve been spoiled. I have great technicians, so it’s always been my technicians, but I know a lot of places that it’s not true.

Dr. Emily Tincher:
I, I’ve been really spoiled too, but I’ve also been as a relief at some practices that are really short staffed and so let’s imagine we’re at one of those or somebody’s day p t o or maybe in a practice that sometimes we’re doing great and having the technicians or the assistants being the ones that are taking the cytology, preparing it and then hopefully our technicians are reading that well, if a veterinarian is the one doing that and someti, I’ve definitely done it myself. Preparing that slide, going and looking at it, reading it and then saying, okay, we have a bacterial infection in this Labrador ears. It doesn’t feel like a big impact and if you do it on occasion, it’s pitching in and helping. If you make that systemic, if you start to do that every day, every week, every month, the case study that Dr.
Walker built out for us says that you can pretty quickly lose up to about $2,400 a week in revenue by just not by veterinarians doing tasks like that, putting in catheters. Other things that are technical staff are much honestly better than doing than me for sure. All of that adds up pretty quickly and from a business profitability perspective, we can see where that’s going, but then having to pass on that cost of the veterinarian’s time to the pet owner perspective, it doesn’t just stop at us. It doesn’t just stop with technicians feeling under underutilized. We also have to pay for that veterinarian’s time somehow. And if we’re chronically, systemically using veterinarians or sometimes licensed technicians in place of assistance where cleaning kennels perhaps that has knock-on impacts to really making it more difficult for pet families as well.

Dr. Andy Roark:
Yeah, I like that a lot. Just as far as increasing efficiency and you’ve kind of look at where do you need your people to be? I have a hundred percent seen practices. I used to do relief work as well. I have a hundred percent seen practices that were short staffed and they were very nice practices, don’t get me wrong, but the vet would swap the ear and do the cytology and then the technician or assistant, it would be the assistant. The assistant would hold the pet while the vet cleaned the ear and I’m like, oh man, you guys are putting in the vets here doing this. The actual technical, a hundred percent the technical work of the case. And I go, this is got to be a smarter way to use this doctor’s time for the benefit of the practice and also for the pets.
Talk to me a little bit when we talk about efficiency and I really like where you’re sort of going as far as letting technicians work at the top of their license is a big way that we retain them. A big part of spectrum care that I think is really interesting is the communication aspect. It’s how we talk to people about what they need and where they’re going and where we sort of understand what support do, are they looking for? What support, what ways can we support them and things like that. Can you talk to me a little bit about using your paraprofessionals, your room assistants or especially your technicians in those types of conversations? What does that look like in a well leveraged practice?

Dr. Emily Tincher:
And it’s another great place that we can lean on some already published data and then talk about the future as well. So in 2022 there’s another jamma publication about the ability and kind of engagement from pet owners when discussing care plans, when there’s some involvement from the veterinarian and some involvement from the technician, that it has this additive effect of really helping pet owners to feel like they understand the value, they understand the buy-in, and to your point from earlier, they’re not hearing two different stories from across the practice. And so how do we talk to pet owners in a way that makes them feel like they know what their options are across that spectrum of care? Again, back to the basic to advance, these are some of the options, these are some of the pros and cons that are associated with that, and then how do we do that in as efficient a way as possible?
Well, one of the things that we’ve done here at Nationwide is to say that’s a pain point and how can we help understand the subconscious drivers behind what people are looking for in pet healthcare? So we conducted some research that we’ve talked a little bit about before to understand that really they’re kind of three different groups of people across demographics and what they’re looking for. And we’re really advocating with be working on a tool that’ll be released later this year, but really advocating for involving the whole team with those conversations. We can set it up sometimes, and it depends a little bit on setting. If you’re in a wellness situation and a general practice, we can really have that education in advance and our technical staff can have most of that conversation already of what is it that is helping this PA family to make their decision?
Are they a cost focused family or are they a group that’s really focused on convenience in their decision making? Those are the two of the three and helping to identify which, what kind of things does this particular pet family value? And then I can talk to ’em about the pros and cons of two or three options that we might have for wellness. Sometimes from a sickness perspective, something’s wrong. Sometimes it can be a little bit easier for the veterinarian to enter into that conversation first and say, I’m seeing we have a pet here that is vomiting on the carpet five times, and we can do things like based on the history you’re telling, based on the physical of what I’m seeing, we’re going to tailor it down to these three stepwise options or go full tilt and go get an abdominal ultrasound after we do some blood work. We can pull those together sometimes as a vet first, but then following up with the details of and the validation, helping our technical staff to feel like they have permission to not just push the most advanced level of care is helpful too. Again, coming back to the very beginning of our conversation of if what we’re asking them to always recommend may not be even accessible to our teams, really how do we feel comfortable instead off offering those options and doing it in a non-judgmental way. Our team can really, really help with that.

Dr. Andy Roark:
Yeah, that’s fantastic. No, I completely agree. It’s going to drive me absolutely nuts. The three types of people, there’s the cost conscious person, the convenience conscious person, well, what is the third one trying? Is it the care focus person? What is it? Yeah,

Dr. Emily Tincher:
Okay. I thought that it’s an optionality focused person, so they really want to know what all their options are. Choice if you like to turn it into three Cs, which is sort that little branding and marketing working there, but the evidence base, that last group, they’re a little bit more complicated. They really want to hear more about, well, your chances of success with parvo are nine out of 10 if we do this. And not everyone needs that level or wants that level of conversation, but I think employing our technicians who can have that level of conversation when they’re experienced and they’ve been with us and sometimes if they’re new grads just like vet new grads, they need to come in the room with us and he hear us have those conversations, but they can, and if Jab MA’s publication about the willingness for pet owners to buy in is if we take that as true, they need to be part of those conversations.

Dr. Andy Roark:
Yeah, no, you are such a wealth of information. I’ve got, well, I’m going to be getting links from you to the wealth of resources that you mentioned today. Is there anything else that you recommend for people? Are there any resources that we didn’t talk about that you really particularly, yeah,

Dr. Emily Tincher:
I think it’s just deciding how is it and having that conversation with your practice. If you’re not yet talking about a spectrum of care or we don’t always have to call it that, really just offering that range of options. That’s just a term so we can all talk about something that many of us have been practicing for a long time. How do we make sure that we’re all on the same page as a practice to say, yes, we agree with this, we want to meet pet families Where they are, whether we do it or not, pet families are they’re, they’re going to ask for options and so how do we just take that barrier down and proactively do that? We have our own website, spectrum of care.com that we can include in the show notes as well. That kind of helps talk about some of those concepts and how you might talk about it with your team and it will be growing with more resources coming later this

Dr. Andy Roark:
Year. That’s fantastic. Where can people find you on online, Emily?

Dr. Emily Tincher:
They can. I’m fairly active on LinkedIn, so it’s probably a reasonable place, but yeah, I love chatting with people and can find me in the uncharted community as well.

Dr. Andy Roark:
Yeah. Cool. Alright, awesome. Thanks for being here guys. Thanks for tuning in everybody, take care of yourselves. Thanks again, Emily, for being here. Thanks for having

Dr. Emily Tincher:
Me.

Dr. Andy Roark:
And that is our episode guys. I hope you enjoyed it. Hope you got something out of it. Thanks to Emily for being here and being my guest. As always, she’s amazing. Thanks to Nationwide for making the podcast possible ad free. Guys, thanks to you for your time and attention. I hope that you guys will be well. I hope you have a great day. See you later. Bye.

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