Wellness

Jamie Holms RVT interviews Dr. Andy Roark about his recent article in Today’s Veterinary Business titled “Measuring Sticks.” They discuss how we determine our own self worth and the tendency for driven people to choose unhelpful and unhealthy measurements by which to judge themselves.

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LINKS

ARTICLE: Measuring Sticks

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

Jamie Holms RVT is a new chicken mom and the Administrative Manager for Dr. Andy Roark, Uncharted Veterinary Conferences. Jamie is passionate about helping the people who are helping pets and is a firm believer that the future of the veterinary profession is bright. Jamie is obsessed with baby goats, axolotls, hedgehogs, tea, plants (especially hoyas), kindle books, food, and sleep – not necessarily in that order.

EPISODE TRANSCRIPT

Dr. Andy Roark:
Welcome everybody to the Cone of Shame veterinary podcast. I am your host, Dr. Andy Roark. Guys, I got my good friend Jamie Holms on the episode. Jamie Holms is RVT. She’s a dear friend of mine. She’s the first employee I ever hired. We go way back. We go back like popsicles on the porch in summertime. That’s how we go back. All that to say, I’ve known Jamie a long time. And when I write articles that really speak to her, she often says, “Hey, can we do a podcast on that article?” And I have an article called Measuring Sticks about how we measure ourselves, how we determine our own worth. And I think a lot of us really driven people have a bad habit of choosing measurements that are unattainable. We measure ourselves in ways that are not healthy, they’re not productive, they make us feel bad. They don’t really motivate us in any sort of way that is sustainable.
And I think that we all should probably take a step back and just unravel the self-talk that we have around what gives us worth and what gives us value, and how do we measure ourselves and how do we measure success. And so anyway, that’s what we get into. If that sounds of interest, then you’ll like this episode. But anyway, Jamie comes on and we talk about the article and I kind of laid down a lot of thoughts about that. So anyway, guys, I hope you’ll enjoy this episode. Always makes me a little self-conscious to get interviewed on my own stuff, on my own podcast, but I don’t know, I write things that I think are interesting and that really speak to me and this is something I’ve been really thinking a lot about. And so anyway, I was really excited when Jamie said, “Hey, I really like that. Maybe we could talk about it.” So I hope you’ll enjoy the conversation. I think it’s a good one. Let’s get into it and see what you think.

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, Jamie Holms. Thanks for being here.

Jamie Holms:
Oh, I’m so happy to be here. Thanks for having me again.

Dr. Andy Roark:
I always enjoy having you on the podcast. For those who do not know you, you and I have worked together forever. It feels like you were employee number @drandyroark.com.

Jamie Holms:
Before you.

Dr. Andy Roark:
Before me, exactly. You hired me on @drandyroark.com and it worked out really well because that was my name and it went great. You are an RVT. We were just laughing that you are a rivett and not a live it.

Jamie Holms:
So true.

Dr. Andy Roark:
So true. You are the administrative manager for drandywork.com and Uncharted Veterinary Conference. And so that’s who you are. You babysit my tomato plants when I travel in the summer and sometimes my bad golden doodle skipper.

Jamie Holms:
He’s not bad. He’s misunderstood and he loves me so much.

Dr. Andy Roark:
He does love you a lot. According to behaviorist Lisa Radosta, he has low confidence, is his problem.

Jamie Holms:
I love that that’s how we ended up here. That’s so funny because I wanted to talk about this article and I told you I wanted to talk about this article and I was like, I think I’m going to lead in with talking about Skipper and his confidence issue.

Dr. Andy Roark:
His confidence issue. Okay, fine.

Jamie Holms:
So this is perfect.

Dr. Andy Roark:
Okay. So I have a goldendoodle named Skipper who is just as a side, he’s not what you would call a good dog. He lives his truth openly and it’s not one of obedience and the thrill of making his owner happy, but he’s his own person and he does have a trait that drives me nuts as he’ll piddle on the floor when people come over or he gets excited. And so I talked to Dr. Lisa Radosta, she’s coming onto the podcast and I had her on to talk about inner cat aggression or something, and I did that thing where I was like, hey, while you’re here, can I ask you about a case? And I told her about Skipper and she asked me a bunch of questions about what he does with his ears and how he sort of behaves.
And the takeaway I think from her not really getting to see him was she thinks that this is sort of a conflict response and that he has confidence issues and that’s why he meets people in piddles. And so I have been trying to work on my golden doodles confidence and it is the most ridiculous project I have ever gone on. But I don’t know, I’m just going to stop and say I do not know if we are making progress. For three or four, five days I’m like, we’re nailing this and then there’s just a setback. And I’m just like, his confidence is it cannot be saved, I don’t think if he’s not a confident guy.

Jamie Holms:
Well, I love this for a lot of reasons. One is that, I don’t know if you know this, but my nickname is Walnut.

Dr. Andy Roark:
I did not know this.

Jamie Holms:
That is not because I am a tough nut to crack. It is because I have a very tiny bladder and I maybe eat abruptly the size of a walnut. And so I always need to pee. And the moment you-

Dr. Andy Roark:
Do you get excited and pee? Do you pee when you meet new people?

Jamie Holms:
I need to pee when I meet new people. I have better bladder control than Skipper does, but that doesn’t make me a better person.

Dr. Andy Roark:
But you have more confidence, I think.

Jamie Holms:
I have more lived experience than Skipper does, but I definitely, the moment someone is like, your flight is going to board in 15 minutes, I’m like, I got to pee. And then they’re like, the flight is now now boarding, I’m like, I have to pee again.

Dr. Andy Roark:
Yeah, I get that.

Jamie Holms:
It’s just how it is. And so I have a lot of empathy for his situation. But it made me think about confidence and I can think about times when I’m really confident, but that made me go well, when am I really insecure? And so I was thinking about that. And so I wanted to start with the deep question. So Andy Roark, tell me what makes you feel insecure?

Dr. Andy Roark:
Oh boy. What does make me feel insecure? Let’s see. Anytime that I feel like I’m not going to live up to the expectation that people have of me, I get insecure anytime that people are like, I feel like people expect something from me that I’m not going to be able to do, I’m much more worried about letting people down than I am not being able to do the thing, whatever the thing is. And so I am definitely insecure about that and singing. I can’t carry a tune in a bucket, and I am very insecure about singing, but I enjoy it when nobody’s around. But those are my two things. Singing and when people feel like they have expectations of me that I don’t think that I’m going to be able to meet.

Jamie Holms:
So I get a huge gift out of working with you, which is I get to read the articles before anybody else does. And so I was really excited when I read this Measuring Sticks article, which went out in Today’s Veterinary Business, and it’s about how we use all of these, especially in the veterinary profession, all of these things from the outside to judge our self-worth and our confidence. You talk about the SATs and your test scores and how people continue to look for that test to take or that new accreditation to get. And I was thinking about that with this, and I love that you are like, yes, I’m in it. I also get insecure when I think I’m not going to live up to the thing that other people want. And in this article you’re talking about how it’s an internal thing, it’s not the things we get from other people. So I love it that you’re like, yes, I also do this thing.

Dr. Andy Roark:
Well, I absolutely do this. So it’s comparison. It’s the flip side to comparing yourself to other people. And so one of my favorite sayings is comparison is a thief of joy. And I see so many people who are so wildly unhappy because they compare themselves to other people. And I think this is the worst thing about social media, and I think there’s a lot of worst things about social media, but this is probably the worst thing about social media is a lot of social media is geared up about getting us to compare ourselves to other people. And we look. And I don’t think people intentionally mean this to happen, but I think we all know it happens at some level, but people sort of post and I can’t help but look and say, man, their vacation looks better than my vacation. Or, boy, they do a lot of things with their kids more than I do. And oh man, I wish I could have gotten free from work to go to the Christmas event at my kid’s school. And wow, look at the fun Saturday they’re having with their dog.
I barely have time to take my dog out and walk a much less spend half the day at the dog park and then go to a cookout. There’s so much of that. But the counterpart to that, which I think is much more common, is the comparison of ourself to some metric that may not be another person. It’s some belief of what we should be doing or what success should be. And so I’ve talked about Skipper before when I talk about what it means to have a bad dog. And the truth is I say that jokingly. The truth is, if you compare Skipper to, I don’t know, Lassie or you say, boy, a good dog comes immediately when they’re called and they’re always right beside you and they don’t pull on the leash and they would never steal food off the table and they don’t piddle on the floor when people come over, then Skipper’s not a good dog.
But if you reset that measuring stick and you say, “I like I want a fun dog, I want a dog that’s always up for adventures and likes to play and squeaks his toys and runs around and is big and goofy and just genuinely funny and happy to be here,” then he is a good dog. But it’s the measuring stick that you set of what does it mean to be a good dog? And so that’s the basic idea with this. But I started writing this thing because I started looking around it and it was a kind of week that came and went. And I just had all these people around me who were just struggling. And one of them was a vet who was struggling. She didn’t think she was a real vet because she only worked one day a week in the clinic and that was really bothering her.
And there was another vet that was really hacked off because friends from high school were messaging her and asking for advice and she felt like she absolutely had to answer them in that moment at dinner and she was just mad. This is dah, dah, dah. And I asked her, I said, “Why do you do this?” And she’s like, “Well, because that’s what I do.” Basically that’s what it means to be a good vet is you drop what you’re doing and you help people who reach out to you. And I’m like, if that’s exactly how you define being good vet, then you are selecting this measuring tool. I don’t believe that dropping what you’re doing in the middle of dinner to ask pet health questions from people in high school is what it means to be a good vet. I don’t buy that.
But that’s a conscious rejection of that ruler for what it means to be a good vet. And so the same thing is people struggling with their confidence because they were not in the top half of their vet school class. And it’s like, I’m sorry, at what time did we all come together and say, “Hey, you know what constitutes being a good vet? The GPA you graduate with?” I wasn’t at that meeting. And if I was, I would not have voted for that because I was not in the top half of my vet school class. And I don’t think that that defines me as a subpar veterinarian in practice. I just don’t believe it.
Hey guys, I just want to jump in real quick and let you know about some great continuing education I have coming your way. Guys, I’ve partnered with Nationwide to put together a series of webinars that are 100%free to you. They have RACE CE, they are good to go, and they are going to be, first of all just genuinely entertaining and fascinating. The first thing I got coming for you is 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’s 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, it’s 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, if you like knowing about seizures, if you like a 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 you there. Links to all this stuff in the show notes. Go ahead and grab a spot, I’ll see you there. Let’s get back into this episode.

Jamie Holms:
Yeah. I think that that’s very true and I think we continue to use some of those weird metrics and they made sense when we were using them. One of the things, my dad said this to me the other day, my dad is 81 and I love him very much and he was having an old man moment-

Dr. Andy Roark:
I have those.

Jamie Holms:
… which he readily admitted. And he was like, “Did you know that those people can’t write in cursive?” And I was like, “Who cares?” That’s not a metric. That doesn’t make them a bad person. Why would they need to write in cursive? And he’s like, well, we had to write in cursive. And I’m like, “Dad, people used to hit you with a ruler because you were dyslexic.” And he’s like, yeah, okay, okay, old man moment. But it was funny because he pulled this random metric that doesn’t matter today. And I know there are people out there who believe that there’s a big cursive argument of whether we should be teaching it or not. And I understand how it helps your brain, I get that part. But is it going to help you be a better person later in life? Probably not. It’s the same thing as your clients aren’t asking you, “Hey, what was your GPA when you graduated?” They care more about your empathy and whether or not you bond with their pet and whether or not you think that fluffy is actually cute.

Dr. Andy Roark:
Doctor, can you write in cursive?

Jamie Holms:
Yes, exactly.

Dr. Andy Roark:
I’m going to need to see someone else.

Jamie Holms:
Yeah, exactly. I love that. And so I was thinking about how funny it is that we do pick these things and we measure ourselves. And mine used to be I judged myself on the number of CE hours that I had.

Dr. Andy Roark:
Oh, wow.

Jamie Holms:
And I, you’ll be shocked to know, always had hundreds and hundreds and hundreds of hours of CE.

Dr. Andy Roark:
You had hundreds of hours of CE?

Jamie Holms:
Hundreds of hours because-

Dr. Andy Roark:
I do this for a living and I don’t have hundreds of hours of CE.

Jamie Holms:
Yes, I know. But I would go home and I would take every CE thing that was in every magazine. I would do every free CE that came from IDEXX or from the food company, whoever it was. I would take all of that CE because I was just like, the more that I can show that I know, the more people will value my contribution, which was never true because nobody else ever saw that.

Dr. Andy Roark:
No one asked you how much CE you had.

Jamie Holms:
No, no one.

Dr. Andy Roark:
They said, do you have enough? And you said yes. And they were like, okay. And that was that.

Jamie Holms:
Great. Yeah, that was the end of the story. But I held myself to that expectation. And then as I went farther out of practice and started using my skills differently, I started doing less CE. And I didn’t abandon it entirely, I still more than meet my needs, but I looked at it differently. And if I was still holding myself to that same thing, I don’t know that I could do that anymore. My brain is older, I have less energy. I don’t know about you, but I used to be able to stay all night and work all day and my brain doesn’t do that anymore. So I love that we’re talking about how to find different metrics.
And I think self-worth is one of those. And I think that that’s something we’ve talked about before, how imposter syndrome and our colleagues just, they don’t necessarily have the self-worth. And I love that I have people on our team that I can turn to and be like, hey, can you hold this mirror up for a second because I can’t see myself well right now? And they can help me with that. And I was wondering if you had thoughts about how we help our colleagues find a different stick. You had some great ideas about things to use, but how do we shift this for the community?

Dr. Andy Roark:
Well, I think a lot of it is, I think we all struggle to see ourselves. You know what I mean? I think we all struggle to see ourselves. At some level, I think we all kind of wonder if we’re a good doctor or we wonder if we’re a good technician or whatever. Are we a good communicator? Are we a good boss? I did a podcast just recently with Dr. Natalie Marks and she was talking about perfectionism and being a practice owner. It was just fascinating to listen to her talk about this. And she sort of told the story of having this sort of realization that perfectionism is a manifestation of fear and that it was detrimental in what she was trying to accomplish. And towards the end of the episode, I asked her, “How did you come to this realization?” Because we were talking about the truth of the situation and kind of how to manage that if you have perfectionistic tendencies, but I was struck, how’d you come to realize this?
And she told this great story about being a practice owner and really wanting to be a great boss and then doing 360 degree feedback because that was what you were supposed to do. And she just got hit by a brick when someone was like, you are super intimidating. And it was absolutely, it sort of hammered her and made her short stop and step back. And so I think we all wrestle with that. I think one other piece of this that I want to tie into this before I start talking about what we can do about it, but again, it feels like a related thing is man, there’s so many veterinarians or vet techs looking at things that they want to do or whoever that are just waiting for permission. Is this idea that they need someone to tell them that they can have what they want or they can do what they want or they don’t have to care about this thing. It’s amazing.
It almost like it takes someone to say to them, “Hey, I saw the Google review that you got where someone wrote a one star review of you as a doctor because they called you at the clinic and it was your day off. I see that and I want you to know that’s ridiculous and that’s not your fault and you should ignore that.” And it seems absurd that someone have to give you permission to look at this obviously flawed thing and say that’s not representative of who you are. But I think a lot of us really want to hear that from someone else. And so I think one of the things that we can do for each other as colleagues is to point out what really matters to each other and just say, “Hey, I saw the impact you had on that person and that was amazing. And hey, I want you to know you’re a good friend and a good doctor. And hey, I always appreciate your insight and you’re a great mentor and that means a lot.”
And I think that people get so sucked up into other metrics that are communicated to them, they often forget about that stuff, but we can point that out to each other. I think the biggest thing for me in choosing the measuring sticks that matter is just being aware of the measuring sticks. I think my greatest hope with writing the article, and now we’re talking to you about this, is that people will just stop for just a minute and say, what measuring sticks am I measuring success with? And again, I have chosen so badly so many times in my life and just the process of stopping and evaluating like, wait a second, how am I measuring myself here? I mean, I used to beat myself up because of the number of hours that I worked or didn’t work in the practice, and I would beat myself up as a parent for the number of hours I spent with my kids.
And at some point I had to stop and say, well, wait a second, Andy, is hours in close proximity to your children, is that the measurement that we’re going to use here? Because I don’t know that that’s the best actual measurement of what we’re trying to accomplish. And the same thing the clinic is like, is me just physically being here, does that actually mean anything? I mean, we’re not talking about the number of patients I see. That’s just me being at the building and I feel guilty if I’m not at the building. And I go, this doesn’t make any sense. And so I just think so many of us, we don’t even question the measurements or other people put them on us. So you get called in for your performance review and the manager is like, “Hey, this is the number of pets that you saw in the last quarter and this is your average client transaction. And from those two numbers, I’m going to tell you if you’re a good doctor or not.”
And I’m like, no, you’re not. No, you’re not. You can tell me how many patients I saw and you can tell me what my average clinical transaction was, but I’m sorry, that’s not a two metric equation that makes a good doctor. I’m not saying those things are without value or we should ignore them, but I don’t buy the idea that I’m going to be summed up by those two metrics. Or you going to give those two metrics and say, this is really what matters. Because I’m sorry, I have my own beliefs about what measurements it takes to be a good doctor. And they’re around compassion, they’re around empathy. They’re around taking time to listen. It’s understanding other people. It’s being honest and acting with integrity. It’s being patient and kind. It’s all of those sorts of things. It’s continuing to learn. It’s being a better doctor than I was a year ago.
All of those things are measuring sticks that I’m interested in. I’m not saying anyone is worth any more than the others, but you just have to be really careful, especially if we get into this mindset of the only thing that matters is how many hours I spend at the practice, how much money I make in a quarter, things like that. You go, man, you’re summing way too much up into this one ruler. It’s not that good a ruler. It’s just not.

Jamie Holms:
Yeah, I completely agree with that. And I wanted to shout both preach and say it one more time for the people in the back because I hear so many people in the community talking about how they’re not good at this thing. We have a really good friend who’s a very good manager, and they are in a circumstance where there’s a new gig in town and a whole bunch of people left that practice.

Dr. Andy Roark:
Wow, brutal.

Jamie Holms:
Yeah. And she’s like, I am a bad manager. It’s like that isn’t why people are leaving. They are leaving because there are different hours. They’re leaving because of all of these other things, and you can’t judge yourself on that one thing. There are 10 other things that I know about you and I know about the people who work with you and your compassion and your care for the animals and for the people that work for you and what you do for our community as a whole. And again, when you’re in it, it’s real hard to stop and say, what is my measuring stick? What’s my measurement of success? And knowing that people look at it differently.
And there are things that we can change about how we talk to ourselves. And I think that would be my challenge to our community is to say, hey, when you hear people say, I am not good at this, or I don’t measure up in this way, or I’m not good enough, I challenge you to do what I like to do, which is to say, don’t talk about my friend like that. And I learned that because I had a really bad self-talk. I continued to have a bad self-talk. And so I learned to ask myself the question of would I say that to a friend? And if I wouldn’t say it to a friend, then I don’t get to say it to me.

Dr. Andy Roark:
I like that a lot. I took that from you, and I use that a lot when somebody will be down on themselves and it’s say, “God, I am the worst. I’m such an idiot.” I will say, “Hey, don’t say that about my friend.” And I learned that from you. And so I really do like that as sort of catching some self-talk. One of the other things going back to our person who’s feeling terrible because people are leaving their practice to go work at a new place that’s opening up is, it’s one of those things about picking your rulers again, going back to how are you going to measure yourself? I think we should all be really conscious and cognizant of the idea that we should not be picking ways to measure ourselves that are out of our control. And I see that all the time. You don’t get to control pet owners. Yet I myself would define, I would say, oh, I’m a good vet because I get good Google reviews.
And I’m like, buddy Andy, you are putting your self-worth into the hands of other people and you don’t have the power to make those people happy. There are going to be people who are just not going to like you and there’s nothing you can do about it. And it’s giving them the power to tell you whether or not you’re successful. I think it’s a bad idea. I think if you’re a manager and you set this bar at like, I’m going to have a hundred percent retention rate, no one’s going to leave my practice. I would say, you don’t have the power to keep these people at your practice. You don’t control what other practices can pay. You don’t control what other opportunities come along. You don’t control where other practices open up. Maybe they’re much more convenient to get to. You can’t control if people are just tired and want to change the scenery. You don’t have control over any of those things.
And so using that metric of retaining other people as the definer of whether or not you’re successful, I go, I think that that’s a bad measurement. I think that’s where I’d probably leave this and sum it up is my biggest thing on choosing the measurements that we use for ourselves is one, just to stop and recognize that you’re doing it. Recognizing. Just stop and say, how am I measuring myself here? I feel like I’m failing. What metrics am I using to come to that result? And what are alternative metrics that might be better? And I think it’s 100% on that. And the other part is to stop and say, what metrics are in my control? Am I picking things that I really do not have control over? And if you are, I think you should really rethink those measurements. I think you should go back to the things that you actually have input on.
And so you should decide what it means to be a good parent or a good spouse, not based on what other people think about your relationship, but what you and your partner think on your relationship or you and your kids find meaning in and what you’re going to look back on and be proud of. But it shouldn’t be, Hey, this is what Facebook says parents should do. Forget that that’s noise. But anyway, that’s sort of my thing with the rulers that we choose for ourself. It’s funny. And a lot of us have this ability to cycle through rulers where we measure ourselves this way and we measure ourselves that way and we measure ourselves this way, and none of the ways we choose to measure ourselves are kind. And I just think that that’s sad and that’s silly.
And so it’s something that I definitely picked up in my life is my younger self always chose harsh measurements. And I told myself that was the right thing to do because it was motivating. It was always motivating. But at some point, I don’t need to be motivated like that anymore. You know what I mean? I am, honestly, I’m doing my best. I’m happy with the work that I’m doing and how I’m doing it. I want an honest measurement, not a measurement that’s going to motivate me or terrify me or make me feel guilty so that I work harder or do things that, I don’t know, that I wouldn’t otherwise do.

Jamie Holms:
Yeah, I think that’s a perfect place to end, and I’d like to invite you to come back and talk with me about the art of kindness in an imperfect world.

Dr. Andy Roark:
Oh yeah. Oh, that’s funny. Yeah, The Art of Kindness article is a fun. It dovetails into this-

Jamie Holms:
I think so.

Dr. Andy Roark:
So the thing I want to talk to you about as well, I think I’m writing this piece right now based on what our friend Maria Pirita said to me recently.

Jamie Holms:
Is it, “Who’s Laughing Now?”

Dr. Andy Roark:
No, it was not.

Jamie Holms:
Oh, dang it. That’s a good story.

Dr. Andy Roark:
She does say, who’s laughing now? And that is a great story. I’ll tell a story at some point. But she was basically, we were talking about mindsets, and her mindset is just, it doesn’t seem that hard. That doesn’t seem that hard. And so when you say something to Maria like, oh man, we got to do this surgery. And she’s like, “How hard can it be?” That was the wording. How hard can it be? And I just thought it’s the best mindset you can possibly have is how hard can it be? And I’ve gotten myself into a lot of trouble with how hard can it be? But I’ve also had the best experiences in my life. I’ve also learned more than anything else, I have also just had the most fun, and I’ve also grown as a person when I have thought to myself, how hard can it be? And then I weighed in. So anyway, I think we’ll talk about that in the future.

Jamie Holms:
I can’t wait to read that article. Thanks for having me.

Dr. Andy Roark:
Thanks guys. And that’s it. That’s our episode, guys. I hope you enjoyed it. Thanks to Jamie for coming on. Thanks to Jamie for making the episode happen, because if she hadn’t said, “I really like the article and I’d like to talk to you about it on the podcast,” I don’t think I ever would’ve flipped on the microphone. So anyway, thanks to her for that. Guys, if you enjoy the podcast, it always means the world to me when people leave us an honest review. It’s how people find us. It gives me some feedback on the work that we’re doing, and it means a lot. So anyway, if you have a moment and you enjoy the podcast, please leave me an honest review wherever you get your podcasts, and or share the episodes with your friends. So anyway, guys, that’s all I got. Take care of yourselves, be well. I’ll talk to you later on.

Dr. Natalie Marks joins Dr. Andy Roark to discuss her recent article on “The Daring Release of Perfectionism.” They discuss how the selection process for veterinary school and success within veterinary school may favor perfectionistic tendencies, and the drawbacks these tendencies have in practice. Finally, they talk about how to manage perfectionism and make peace with it.

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

LINKS

ARTICLE: The Daring Release of Perfectionism

Marks DVM Consulting

Dr. Natalie Marks on LinkedIn

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

Clinical Empathy Webinar with Dr. Andy Roark and Dr. Emily Tincher

ABOUT OUR GUEST

Dr. Natalie Marks obtained her bachelor’s degree with High Honors in Animal Science from the University of Illinois in 1998, and then proceeded to obtain a Masters in Veterinary Medicine and Doctorate of Veterinary Medicine degree with High Honors from the University of Illinois College of Veterinary Medicine. She became a Certified Veterinary Journalist in 2018.

She has been a veterinarian at Blum Animal Hospital since 2006, co-owner until 2018 and current associate. Prior to 2006, Dr. Marks worked at Allatoona Animal Hospital just north of Atlanta, GA. Her media experience began in print when she created several monthly veterinary columns in multiple community magazines and was a frequent guest speaker for the German Shepherd and Bernese Mountain Dog clubs of Atlanta.

Upon her return to Chicago, Dr. Marks became very active in the Chicago Veterinary Medical Association, serving on the executive board. She was also a past board member of the Illinois State Veterinary Medical Association and an active volunteer to the American Veterinary Medical Association and American Animal Hospital Association.

Dr. Marks has received many prestigious awards in her career. She was awarded the Dr. Erwin Small First Decade Award, presented to a veterinarian that has contributed the most to organized veterinary medicine in his or her first decade of practice. In 2012, Dr. Marks was awarded Petplan’s nationally-recognized Veterinarian of the Year. In 2015, she was awarded America’s Favorite Veterinarian by the American Veterinary Medical Foundation. And, most recently in 2017, she was awarded Nobivac’s Veterinarian of the Year for her work on canine Influenza.

Dr. Marks is also very passionate about educating in all aspects of media, both locally and nationally. She has appeared on Good Day Chicago, WGN-Pet Central, NBC Morning News, ABC, CBS, NPR, WBBM, Northwestern University media channel and many local websites. Dr. Marks was featured nationally on the Today Show and CBS Nightly News during the canine influenza epidemic of 2015 and in multiple issues of JAVMA. She is a guest contributor in multiple media campaigns for Merck, Zoetis (formerly Pfizer), Boerhinger-Ingelheim, Ceva, Trupanion, Aratana, ScopioVet, and Royal Canin.

Dr. Marks is a regular columnist in Today’s Veterinary Business, Healthy Pet magazine, and Pet Vet, and has been published in Veterinary Medicine magazine, DVM magazine, Dogster, and Vetted. She is on the Advisory Board for Health Magazine and also was the host of numerous veterinary broadcasts for the Viticus Group (formerly WVC).

She is a desired national and international lecturer for many of the same companies at VMX, WVC, AVMA and regional conferences, and most recently was a featured speaker at Ceva Sweden’s Derm Day and the Royal Canin Global Symposium.

Dr. Marks finds the ideal combination of teaching/mentoring and improving the emotional health of pets in the Fear Free movement. She sat on the Fear Free Executive Council and is a national educator helping other private practitioners develop these techniques. She also led her practice to become the 7th nationally and first practice in Illinois to become a Fear Free Certified Hospital. She is an Elite Fear Free Certified Professional.

Finally, Dr. Marks is a serial entrepreneur, angel investor and consultant, and one of the newer members of VANE, the Veterinary Angel Network.

When Dr, Marks is not working, she treasures her time with her family and her three wonderful children: Sophia, Evan and Madeline. Dr. Marks loves traveling, scuba diving, cooking and spending time outdoors, especially anywhere there is a beach!

EPISODE TRANSCRIPT

Dr. Andy Roark:
Welcome everybody to the Cone of Shame Veterinary Podcast. I’m your host, Dr. Andy Roark. Guys, I am here with my friend, Dr. Natalie Marks. She’s amazing. She’s a practicing veterinarian. She’s an entrepreneur, she’s a lecturer, she’s a writer. She does so, so many things. I really love an article that she wrote called The Daring Release of Perfectionism, and she talks a bit in this article about dealing with perfectionistic tendencies as a leader in practice, as a veterinarian, as a colleague.
And then when we get into this episode, we talk a little bit about her own sort of epiphany that perfectionism was undermining what she was trying to do and how she sort of wrestled with that. Man, this is one of my favorite conversations of the year. It really is. I hope you’ll give this episode a chance. If you see yourself as a bit of a perfectionist, if you work with people who are perfectionists and you recognize that it’s a double-edged sword, this is a really good episode. So anyway, I hope you’ll really enjoy this. Dr. Natalie Marks is amazing. 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. Natalie Marks. Thanks for being here.

Dr. Natalie Marks:
Thanks for having me back, Andy. It’s good to be here.

Dr. Andy Roark:
It’s wonderful to have you. You have been here at least three times. I really enjoy you. You are my discovery of 2023, I think. I don’t know that you were on before 2023, and now I can’t have you on enough. I enjoy so much that you’re doing. For those who do not know you, you are an educator, a consultant, a practicing veterinarian in Chicago. You are a leader in the Fear Free movement. You were a member of the original Fear Free Advisory Board. You have won crazy awards that I have to say I’m super jealous of. You were in 2012, you won the pet plan Veterinarian of the Year award, which I was involved with putting on that ceremony and stuff. And so if people don’t remember, it was a big deal. You were voted America’s favorite veterinarian by the American Veterinary Medical Foundation. You just rack it. You rack up big awards and you’re doing so much. It’s amazing to me. You make me tired and I do a lot.

Dr. Natalie Marks:
Oh, my gosh. Well, that’s saying something. I feel like you’re always on the go too.

Dr. Andy Roark:
Oh, man.

Dr. Natalie Marks:
Well, it’s interesting you bring that up because it sort of relates to what we’re going to talk about today, which is just that overachieving drive that a lot of us also coincidentally have with perfectionists. And so I’m curious to see what we can tease out.

Dr. Andy Roark:
Yeah. No, I agree. I think it’s funny. You’re exactly right in that that is the setup for where we’re going. You wrote an article that I saw and I really liked. It was in Today’s Veterinary Business, it was called The Daring Release of Perfectionism. And in it you talk about, you say that our colleagues, clients, and patients are better served when we simply strive for excellence over perfection. And so, one of the things sort of appreciate about you is I see a number of my own tendencies of just have “I have to be the best. We have to accomplish more. We have to make a bigger difference. We have to get more things done.”
And I really personally wrestle with this a lot because you can push yourself for perfection to the point that it becomes counterproductive. And I have often struggled with trying to figure out where that line is of pushing myself hard enough that I continue to make progress and feel good about what I’ve done at the end of the day, but not push myself into the negative place that I’ve been before where I’m like, “Andy, you’ve got to let some of this go.” So let me sort of pause there and let you sort of lay out your thesis on perfectionism.

Dr. Natalie Marks:
Yeah, as you mentioned just when we were chatting, it is a really significant double-edged sword, but I think has sort of overtaken the veterinary industry because so many of us, just to even get into veterinary school, we were told we have to do get almost straight As. Our academics have to be stellar and we have to do all of this sort of extra internships or volunteerism ahead of time. And you should have done a research project and maybe should have also have these recommendations, which means you have to do this extra. And it’s all about truly overachieving, because there were only so many spaces with how many applicants. Although the situation has changed a little bit, certainly with the shortage of veterinarians. But certainly when you and I were in school, that’s how it started.
You get into school and it’s throw, how many, 36 hours of caseload at you every semester. Many of us had jobs, many of us were volunteering, working at clinics. But I think the underlying theme that connects that… As Taylor, we were talking about Taylor Swift. The invisible string that connects so many of us is that we want to be perfect. It starts in a healthy way. And I think many of us maybe were raised that way or encouraged that way or genetically have some of that in us or all of the above. Nature versus nurture, however it was, we ended up at the same place that in order to be the best, we have to be perfect. And what I found as I was sort of thinking about this and reflecting on especially my year as practice owner, I found that it often led more to detriment than to benefit. Not just me, but to my team, to the families and clients I was working with, to my patients, to my family, to my friends.
And the key though, and I think the trick is identifying it in the moment versus having to do this reactive approach that I’m doing right now. It’s hopefully helping obviously in this next chapter of life, but so many of us have our blinders on and are so busy in the muck of practice, and I say muck in the most positive way, but you’re in that daily grind and not realizing that if you just take a few of, hopefully the tips and tricks we’ll talk about today and apply them. These are not major things. These are sort of, if you’ve read about atomic habits, these are little things that can make a huge difference in how you feel, how you present yourself, how you’re received. But I think the goal of all this is how can we make veterinary medicine a lifelong career? I think that is a key of why so many of us have left, why a lot of people have said, “I just can’t do this any more,” because of this.

Dr. Andy Roark:
Well, there’s so much to unpack there. So I completely agree. I think we select for perfectionists going into vet school. And so those are the people who go through the hoops and set themselves in a place where they get selected. And then when we get trained, I think we train people to be perfectionists. And again, I know things in vet schools are changing and their curriculum is evolving and I think it’s wonderful, but generally we don’t work collaboratively in vet school. We work as individuals and we are graded on our perfection, on our completeness. And so I think that we select for people who have that fixation and we further train to that. And then we put them out into a scenario where honestly being a perfectionist, just from a pragmatic business standpoint, is really limiting. The vets that really thrive are ones who are okay with something not being exactly perfect as long as it’s good enough and they didn’t have to do it.
And it’s like that’s how you leverage staff. That’s how you’re able to get work done. But if the only way that something is good enough is if you yourself do it. There’s no way out of that. It’s absolutely limiting. Can you flesh out some of your comments, because I think this is important to get our heads around? So you say perfectionism is not ideal for our team, it’s not ideal for our patients, it’s not ideal for our clients. Can you sort of flesh out what that looks like? I think some people would say, why is perfectionism not ideal for our patients? How is that true?

Dr. Natalie Marks:
Right. Well, so let’s start specifically just right with medicine. And what I think both of us… And I don’t mean to speak for you, but I would assume you would feel this way. We aren’t saying, I’m certainly not saying, just strive to be sort of average. If you’re doing surgery in an average way, that’s fine. Not at all where we’re getting at. But I think a perfect example, and I’m glad that I went right to surgery because I think this is a key. When we as perfectionists, we often will think to ourselves one of two scenarios. Let’s say you are brand new associate and you’re like, I have a client that comes in and they want to have a gastropexy and you’ve never done a gastropexy. Many perfectionists will actually do one of two scenarios. They will either say to themselves, I’ve never done this before. I don’t want to fail, so I’m not even going to learn.
I’m not going to take the steps. I’m going to decline this. I’m going to shy away from this because if I can’t be perfect, I shouldn’t even try. But there’s another camp of perfectionist that will say, I’m going to admit to myself I don’t really know what I’m doing, but I would never let anybody see that fear. I would never ask for help because God forbid they see me having a vulnerability. So I’m going to try this surgery even though inside I’m terrified and I might make mistakes, and you probably will make mistakes, and the patient’s going to be under anesthesia longer. You’re not going to understand the shortcuts. And perhaps there’s going to be even complications, God forbid, but they might be. So both of those scenarios perfectionists can lean to. But if you notice, those are extremes.

Dr. Andy Roark:
Yeah.

Dr. Natalie Marks:
What we want to think about is how can I take fear, which fear is such a innate and sort of natural survival instinct we all have, but we don’t want to be guided by it. I work with a life coach, and she gave me this amazing sort of imagery of how to keep my fear in check. And in my head I have a boardroom, and I’m sitting at the head of the table and I have all my emotions sitting in their chairs. And every emotion that I have when I’m thinking about a decision has a voice including fear. But fear can have that voice and then I can say, “Okay, fear, I’ve heard you, but I’m going to take the consensus and figure out what my view is.”
And so when you have a situation like that, instead we’d love to encourage and hopefully teach and mentor the hybrid model, which is, “Okay, I hear you fear. Never done this before. I get that. That’s noted. That’s needed.” We have to have some of that healthy sort of wary optimism.
But I also heard that in that bravery of saying, “I’m going to try it,” you probably need a little bit of help. So let’s take the cautious nature, but let’s take the bravery and let’s meet in the middle. Let’s ask someone for help. Let’s go in for guidance. Let’s take a little bit of extra study. Let’s take a course, but let’s find that healthy goal of helping that patient but also having that self achievement without the worry you’re going to fail or without even trying. And so that’s what I mean by around our patients. We can either not help them at all or we can be too bold because we don’t want to show vulnerability. And I think that’s one of the keys of perfectionist is they’re so scared… again, I’m speaking as a recovering one… so scared to let somebody see you fail most of all yourself. Even though that often doesn’t happen.

Dr. Andy Roark:
I like this a lot. I was talking just a couple of days ago with Dr. Ivan Zack, and so he’s the CEO at Galaxy Vet, and just a genuinely neat, interesting guy. And he said, I’ve never heard it bluntly, but he said, “Perfectionism is fear.” And he said, “That’s what it is.” And now that you’re talking about fear… And I sat with that a little bit and said, “Is that really true? I hear what he’s saying, but is that true?” And then as you’re saying, “Well, there’s really two different paths, but they’re both fear driven.” I go, “Oh, that’s sort of starting to square up.” Do you generally agree with that assessment?

Dr. Natalie Marks:
I do. If you think about if this is relating to you, if you’re sitting there going, this is me, this is me, if you think about how perfectionism guides you… And let’s take another aspect, let’s say with your team. So say you are a leader in your practice in some regard, whether management or a peer leader or a champion for some aspect, and you’re tasked with a project that you have never done or is quite large or means stepping into a whole nother realm that maybe you failed at before even. Perfectionists, again, tend to go to extremes.
They tend to, and I think I wrote in my article about silent expectations. They often feel like if I have this expectation that this project has to be perfect, then I’m going to not really tell people around me what I need them to do and help me with because I don’t want to be bossy. I don’t want to come across as taking over because I have that fear of being looked at that way. But also then I’m never clear. I don’t give expectations of what our goals are. And then when someone presents me with something they’ve done for this project, then there’s inherent disappointment which often in body language is communicated to the team member, which then of course creates this conflict.
So to your point, led by fear in both scenarios instead of finding that middle ground of saying, “I understand I’m me and I understand you’re you. And for this project, our expectations are such. And so I want to discuss with you, same way we do shared decision making in the exam room, I want to discuss with you, this is what I want out of this project, but what do you want out of this project and how do we find that shared goal together so that expectations are out, they’re on the table, we know exactly what they are, we hold ourselves accountable for our roles and then we regroup.”
I didn’t do that as a young owner. I didn’t want to be that person because especially I think a lot of them are the associates, which I was, that then become owners and you’re working with the same people but in a different role, and you do not want to be looked at as, if I can just say it, a bitch the that just bought the practice. So you come out there and you are just like, “Well, whatever you think you can do,” but that never ends well. But that stems from this perfectionistic tendency of I expect here, and I assume everybody else thinks they should be up here, but that’s not the case and nor is this case healthy. So we have to sort of bring down, yeah,

Dr. Andy Roark:
Is it perfectionism kind of getting trapped in two spaces? Do you think it’s perfectionism of the job has to be done perfectly and I don’t want to make other people feel micromanaged and I want to be the cool boss and I don’t want to be the boss that people don’t want to work for. And so then you’re completely stuck at that point because you’re like, “It has to be perfect, but I don’t want to really communicate my expectations because then I will not be this other part of perfection.” It doesn’t seem like there’s any way out of that if you set yourself up that way.

Dr. Natalie Marks:
Yes, and that’s the key is that… I wrote this article because as I was reflecting on my first several months of ownership, I was thinking if I was mentoring people, which I do, what advice would I give them now as these young owners, whether they’re in sort of a corporate partnership or they’re independent, but whatever that is, if they are in this role, what is a better way to start? And again, I don’t like to look back on regret. I like to look at everything in life as a learning opportunity. And so I think this is just a way for us to think about how can we set ourselves up, especially to improve work culture, because that’s really where this is stemming from. Every person, especially perfectionists, they feel very, very nervous about someone else seeing a flaw, because to them a flaw creates extreme anxiety.
And I think we all know that. Even though many of us have failed, if we look back in life, we failed. Sometimes we ignore the failure. Sometimes we are embarrassed about the failure. We do come back, but many of us don’t go back in the same way or don’t even go back to that same experience because it’s so traumatic for a perfectionist. However, if we reframe that and say, how much could someone learn from you being vulnerable enough and brave enough? Those two can go together. That’s the thing. We don’t often think that bravery and vulnerability are together. We often think vulnerability is a weakness. It is a strength. So if you are brave and vulnerable in the same time as a practice leader and demonstrate, not be embarrassed, but just demonstrate the humility of a flaw or we’ll say a perceived failure, because often it isn’t. Often what we perceive as a failure is a minor blip in the road, but to a perfectionist, it’s a catastrophe.
But then show how we learn together. You misquoted a client, how do we learn from that experience? What process can we create so it’s better next time? Something happened in a surgery, no one’s perfect. How do we learn from that experience? How do we teach someone not to do the same thing and then get that personal reward out of mentorship? So I think it’s all about reframing it and understanding that, again, a brave vulnerability is I think how I choose to lead as I move forward, is to say it takes a lot to show somebody that I messed up. It takes a lot to admit a mistake, especially as a perfectionist, but the reward that you get from that vulnerability is actually so much more bucket filling than we realize.

Dr. Andy Roark:
Yeah, I love that you say that. And having that behavior modeled, that is something I feel like I’ve seen a lot more in the last say 10 years than in 10 years before that. And I had a couple of mentors. So I’m a Florida grad, and Uncle Mikey as we call him, Dr. Michael Scher was at Florida. That guy was absolutely brilliant, absolutely brilliant. But he would talk in rounds about his pile of bones, he’d be like, “Yeah, I remember him. I missed that one on my pile of bones.” And I remember just, I liked him so much in the time, but for someone who’s a bonafide… And maybe you would say, “He’s such a bonafide genius, no one’s questioning his competence.” But I thought that was such wonderful behavior and philosophy to say, “Well, I’ll tell you about how I messed this one up.” And it made an impression on me to have this person who I just respected so much being willing to say, “Well, I’ve made these mistakes.”
Hey guys, I just want to jump in real quick and let you know about some great continuing education I have coming your way. Guys, I’ve partnered with Nationwide to put together a series of webinars that are a hundred percent free to you. They have Ray-CE, they are good to go, and they are going to be, first of all, just genuinely entertaining and fascinating. The first thing I got coming for you is 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’s 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. And 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, it’s 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 a 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 you there. Links to all this stuff in the show notes. Go ahead and grab a spot. I’ll see you there. Let’s get back into this episode.
I was having a conversation with my team, and this comes from a practice manager named Maria Pirita, who I work with who’s amazing, but she’s one of the most optimistic, positive people, can do people I meet. And her life philosophy as she told it to me was, “How hard can it be?” And I’m like, that’s such a wonderful… So that surgery, she would look at the surgery and go, “How hard can it be?” I just think, how refreshing is that? How wonderful would it be to have that be at least one of the driving voices in your mind of, other vets do it. I’ve done a lot of surgery. How hard can it be? And I love how you put it. I love your sort of board of directors where I’m just like, I’m not saying this is the defining voice, but it’s one of the voices. And I think a lot of us have lost touch with that how hard can it be voice?

Dr. Natalie Marks:
I love that too. And I think that speaks to, and again, we’re sort of this underlying tenet of fear is that a lot of us go into… And let’s just even take practice ownership. We’ve been talking about it as an example. A lot of people look at practice ownership. And maybe if they allowed themselves, again, I call that daring release because it’s not easy. It’s not easy to release that sort of… It’s almost like a body suit. It’s this control and sort of this safety in a way of sitting in this space of perfectionism. But when you let that go, and it can be slowly at points and starting with baby steps, but you let that go and you actually look at yourself and say, “What do I want? What do I want right now out of life?” And if that’s to you, it’s like, I want to be a practice owner. And then that ugly fear that’s sitting on your shoulder goes, “You can’t do that. Are you crazy? That’s insane, blah, blah, blah.”
You have to listen to it, but you don’t have to follow it. And that’s important I think, because we don’t want to get rid of all of our fear. Fear is needed in small… Otherwise, fear would say, “I’ve got a cliff. I could just walk off. I can fly.” Fear is needed, but fear also is, if we think about where that started, it was because when we were living in caves and there’s a saber-tooth tiger around the corner, fear kept us in the cave and away from threats. And it’s still there, but we have a much better way of controlling it. And how hard can it be? And so the other thing I think that has been really helpful as I’ve been working on this journey of releasing perfectionism is exactly what you mentioned, which is surrounding yourself with people who think about the world differently. Perfectionists tend to want to stay around perfectionists because it’s like safety in numbers. It also feels better for someone to say, “Oh yeah, totally. I agree with you a hundred percent.”

Dr. Andy Roark:
Yeah. It validates what you’re doing and how you see it. And it validates your fear as well. They’re like, “Oh yeah, I would never let someone else do that.” And you go, “Okay, good. I feel good about this.”

Dr. Natalie Marks:
And then you’re like, “Of course I knew it. I was perfect,” and it’s just sort of this vicious cycle that you again trapped and you can’t get out of. But when you allow yourself to be surrounded by people who have different ways of looking at the world, have not necessarily struggled with the challenge of perfectionism, but strive for excellence, that healthy hybrid form, it challenges you to think about what if I did look at it that way? Or what if I did take a step back? What I just saw is a massive mistake. Maria might’ve been like, “That’s nothing. What’s going on? Why are you thinking that way?”
And the more that you allow yourself to internalize those other comments, the more you can validate that you know what, that was a little minor mistake and everybody makes them, and I’m going to move on, instead of internalizing that and having it stay with you for days and weeks and affecting other parts of your life. And I know that I definitely did that as a younger associate, and I would let a case just linger and fester for a long, long time instead of surrounding myself with people who could allow me to think differently, but also being brave enough to say, “Yeah, I made that mistake. I can’t believe I did that, but I did do it. Help me get through it.”
Because we get embarrassed and we just sort of wallow in this alone. And being alone in perfectionism is awful, absolutely awful because not only do you feel alone, but there is nobody there… Again, I’m going to just keep using Maria… I hope I get to meet her someday… being that beacon of light that says, how hard can it be? It was one mistake. You quoted the client $450 instead of $500. Yes, the client’s response was as such, but it’s not that you’re the worst person. Let’s just think about a different way to diffuse a client next time you’re on a call.

Dr. Andy Roark:
Yeah, I love it. Natalie, was there a turning point for you? Was there something that made you stop and sort of assess? Because you clearly thought a lot about this. And you say sometimes you have a before version of yourself and an after version of yourself. What was it that sort of made you stop and take stock?

Dr. Natalie Marks:
Yeah, it was probably one of the hardest days of my veterinary career, and it was actually, we had been doing, I was a practice owner, we were doing reviews. And we had of course our team review us, myself and two partners. And I had set myself up in the safe space of perfectionism of saying, “Oh, well, look at all this great stuff that’s coming back. You’re a wonderful mentor. You teach us, you do rounds with us,” and all this stuff. And then all of a sudden, I had three comments from newer team members who said, “You’re really intimidating and unapproachable.” And I’d never really had that direct feedback before, especially from a position of leadership.
And if I thought about it in the moment, certainly now as I reflect, of course I have many different feelings on it, but in the moment, I remember hearing that from my senior partner, delivered in a way that I think if I had delivered that now would be different, but sort of just this very direct, almost like a brick hit me. You’re pretty intimidating and really unapproachable, and they don’t really feel like they can come to you. In that moment, I know I went home, I didn’t eat for two days. I had stress colitis. I’m thinking, how do I even go on? You start to ruminate and go into this spiral of, I must be the worst practice owner anyone’s ever had. Oh my gosh, if people think of this here, do my friends think I’m that way and they just don’t tell me? Do my kids think I’m that way? And you go into this really dark place.

Dr. Andy Roark:
Yeah.

Dr. Natalie Marks:
And my best friend at that moment said to me, “You’ve got two choices. That’s what you got here. You can sit here and continue to wallow,” because it had been days of me really being in this dark place, “continue to wallow, and you are going to lose everything you worked for.” Because practice ownership at that point had been my veterinary goal and I’d finally achieved it, “And you could lose everything. Or you can take this and you can say you don’t want to be looked at that way because the way you’re acting, it sounds like you don’t. And you can be super brave and sit down with those three people and get feedback on what they are seeing because you obviously aren’t seeing it. And it’s going to take strength and it may even go down a little bit more before you go up, but you’re going to go back up.”
And I thought it took a lot of guts for me to sit down with those people because they did give me a lot of feedback that I wasn’t necessarily expecting or even in the moment wanting. But I wrote it all down and I sat with it. And I said, “You know what? This is probably the bravest thing that I’ve ever done for myself, but it’s also the bravest thing you’ve ever done because they definitely didn’t need to give me that feedback.” But I realized that’s not the leader I want to be. And so it took a while though to tease out why was I looked at that way. And that’s where I came kind of to those silent expectations. That was a big part of it for me is working on projects with team members and not giving them transparency and not showing my weaknesses, realizing that instead of them looking at them as weaknesses, they would realize that I’m human too. It humanizes leaders to be that way, and perfectionists just don’t see that in the moment.

Dr. Andy Roark:
No, I love that. Thank you for telling that story. And again, I resonate with that so hard. I know exactly how you feel because you want to be the best boss and you want to be the best manager and the best doctor. And then when you get hit with feedback like that, sometimes it’s really hard to let it go, if that’s what you really care about.
The way I came into thinking about perfectionism just for myself is very much… I ended up in sort of the same place as you. At some point you just get tired of getting trapped again and again. And ultimately, you have to pick your poison. And I think your friend was so spot on. You can just continue to do this or you can decide that you’re going to try to make some changes. But those are your only two options. Keep doing what you’re doing or do something different. Anyway, I love that you shared that. I love this conversation so much. Dr. Natalie Marks, you are absolutely amazing. Thank you for being here. Where can people find you online? You are doing so much. I love your column in Today’s Veterinary Business. Where else can people find you and follow you?

Dr. Natalie Marks:
Yeah, I do a lot on LinkedIn. I’m certainly doing a lot educating. My website is marksdvmconsulting.com if people want to check out a lot of the articles and blogs and where I’ll be next. But I’m certainly around and I really am on Facebook and Instagram too. But I love, just like you, I love connecting with colleagues, and I think this issue is one that has sort of remained behind the screen and behind that big curtain for a long time. But I think the more that people talk about this and realize there’s a huge community of recovering perfectionists out there that have been where you are. And if you’re feeling this way, don’t feel like this is the end, that I’m a perfectionist, it’s ingrained in me, and I will never be able to change. Small steps make a big difference.
And also, one last thing I would say is you need to recognize the joy along the journey. We’re so committed to, it’s got to be if we don’t hit the ultimate goal, the only way we can really find joy is the end result. Only for a second, because then we got to move on. It sounds so trite, but stop and smell the roses and the little, little pieces along the way because that’s where we find purpose and meaning. And often that’s even more rewarding than the end of the journey.

Dr. Andy Roark:
Oh man, you’re speaking to my soul. Anyway, we could have a whole other conversation about that.

Dr. Natalie Marks:
We certainly could.

Dr. Andy Roark:
We’re going to stop here, but I have lived that reality so much. And I’ve come to the same place as you. You’ve just got to let some of it go. You got to stop and smell the roses. Thank you so much for being here. Guys, thanks for tuning in, and everybody take care of yourselves. All right? And that’s it. That’s what I got for you guys. I hope you enjoyed it. I hope you took something out of it. Dr. Natalie Marks, thank you so much for being here. She’s absolutely fantastic. Gang, take care of yourselves. Be well. I’ll talk to you later on.

Jamie Holms, RVT joins the podcast to interview Andy about one of his recent articles. The struggle to take ownership of what we can while knowing when to accept things that are out of our control is never easy. In this episode, Jamie and Andy talk through where those distinctions become challenging in veterinary medicine and what to do when its hard to tell the difference.

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

LINKS

Article – Back to Reality:
https://todaysveterinarybusiness.com/back-to-reality-discharge-notes-0223/

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

Jamie Holms RVT is a new chicken mom and the Administrative Manager for Dr. Andy Roark, Uncharted Veterinary Conferences. Jamie is passionate about helping the people who are helping pets and is a firm believer that the future of the veterinary profession is bright. Jamie is obsessed with baby goats, axolotls, hedgehogs, tea, plants (especially hoyas), kindle books, food, and sleep – not necessarily in that order.

Fun Fact: Jamie’s a Slytherin

EPISODE TRANSCRIPT

Dr. Andy Roark:
Welcome, everybody, to the Cone of Shame Veterinary Podcast. I am your host, Dr. Andy Roark.
Guys, I have my dear friend, the one and only Jamie Holmes on the podcast today. We’ve done a couple episodes together. She is a reader and a deep thinker, and every now and then, when I write some things that speak to her and she wants to unpack them some more, she’ll reach out and be like, “Hey, how about I interview you on the podcast?” And that’s what happened today.
Anyway, we’re talking about one of my recent articles called Back to Reality. It is all about trying to figure out what to accept because it’s out of our control and what to not accept, because we do have more influence than we think. How do you parse those things apart? And how do you know when to lean in, and how do you know when to lean back? That’s what we talk about.
Man, I love these conversations. I love talking to Jamie. I hope it’ll be an interesting conversation for you guys. I always love thinking about these things and trying to figure out, when the chaos comes, how do I best use my emotional energy? And that’s really what we get into. Anyway, guys, I hope you enjoy it. Let’s get into this episode.

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

Dr. Andy Roark:
Welcome to the podcast, Jamie Holms. How are you?

Jamie Holms:
I’m really good, Andy. I’m so excited to be here and maybe creep you out a little bit about how I backstock on your articles to see if they still hold up.

Dr. Andy Roark:
Oh, no. Oh, no. For those who don’t know you, you are an RVT. You are employee number one.

Jamie Holms:
I am.

Dr. Andy Roark:
At drandyroark.com.

Jamie Holms:
That is right.

Dr. Andy Roark:
And the Uncharted Veterinary Conference. You were.

Jamie Holms:
That’s right. We don’t even count you.

Dr. Andy Roark:
No, I’m not an employee. I have yet to set up payroll for myself.

Jamie Holms:
It’s true.

Dr. Andy Roark:
It is true.

Jamie Holms:
Sometimes, I worry that we don’t pay you and you’re going to leave.

Dr. Andy Roark:
Yeah, no, I just hang around. This is a hobby. As soon as I get paid, then, it won’t be … It’ll work, then.

Jamie Holms:
It won’t be fun anymore.

Dr. Andy Roark:
It’ll be work then. Yeah, then, it’ll be work. So yeah, no, no, no. And we’ve been around, been together a long time, Jamie Holmes.

Jamie Holms:
We have.

Dr. Andy Roark:
The last time you were on the podcast was episode 100 and-

Jamie Holms:
Whoa.

Dr. Andy Roark:
Yeah, it was episode 100, and it was the stories we tell ourselves matter.

Jamie Holms:
Oh, yeah, absolutely.

Dr. Andy Roark:
And that’s what we were talking about. And I looked back at it and I was like, “Oh.” Anyway, it’s been a minute, but as you say, you do to backstock the articles that I write.

Jamie Holms:
I do.

Dr. Andy Roark:
And you I, we discuss these things and get into what does this mean, and philosophically, what is going on in our profession. Anyway, I thought we were probably due for one of those and you said, “I got something I would like to talk to you about,” so I thought I would just bring you on and open it up and let’s talk about what’s on your mind.

Jamie Holms:
That’s perfect. I was reading the article that you wrote, Back to Reality, for Today’s Veterinary Business, and there are some things in there that really hit me. And I was talking to my dad about them, because we’ve been talking a lot about agency recently, and that’s what this is about. One of the things that you said that your brother said to you, and I also didn’t like it, is, you have zero power in this situation.

Dr. Andy Roark:
Oh, yeah. I had to go look at this article, to be honest. You were like, “I’m going to talk to your Back to Reality article.” And I’m like, “I’ve no idea what I said in that article.”

Jamie Holms:
Yeah. For sure.

Dr. Andy Roark:
It’s a little bit of a deep cut and I’ll link it in the show notes, for sure. But it’s funny, I went and looked and I was like, “Oh, I remember this.” It was when I got called for jury duty and I had to go, and I was really busy. We were trying to get one of our conferences off the ground and it was not at a convenient time at all. And I got the jury summons and I’m like, “Oh, man, you got to be kidding me.”
So I reached out to my brother who’s a lawyer, and I was like, “What can I do to not have to do this?” And he was like, “You have zero power here. Zero power.” He was like, “Just go and be nice and hope for the best, but you have zero control.”
And I did not want to hear that. I wanted to believe that I threw charisma or willpower or that through financial strengths, I’m like, “Who do I write a check to get this week of my life back?” And he’s like, “It does not work that way. That’s not going to happen. You have no power.” And it struck me because of how rarely someone says to our face, “You have no control over what’s happening right now.” But it hit me pretty hard and I had to sit with that, and I panicked just to be like, “I have no agency at all here.”

Jamie Holms:
That’s such an extremely difficult place to be. And I think we find ourselves in that place, in veterinary medicine, so often, whether it’s the volume of calls that are coming into the front desk, whether it’s that the phones stopped ringing because the internet is out and our phones are linked to the internet and people can’t get through, those kinds of things.
And I specifically really related to the part where you talked about time taking a toll on your body and you not having any control over that. As you know, I lost both of my knees during COVID, we have mourned for them, and I find myself really comparing myself to who I was three years ago and what I could do three years ago.
And I find myself getting really stuck in those places and not doing everything that I can because I’m so focused on what I can’t do. And I think that we get into that head space in vet med and in our practices when we’re faced with these, whether it’s just one emergency after another, whatever it might be, we really get stuck in those spaces. So I wanted to talk to you about some of the things that you do to put yourself in the right head space and the day-to-day. How do you talk to yourself to practice this? Because it’s a muscle, right? You’re having to flex this muscle.

Dr. Andy Roark:
Okay. I don’t know that I’m the best person to talk about this, Jamie, because it is a bad … I’ll be honest. You write the book you need to read. I think that I’ve written numerous iterations of this article in different ways with different stories because I continue to battle it.
It’s funny you talk about losing your knees. I used to run a lot. I used to love it, and I like being outside and I like having this thing, I run with my dog and stuff like that. And man, I started, when I was probably 35 or so, I got my first bout of plantar fasciitis and my feet hurt and I had to stop running for a while. And then, I got it again later on and I’ve just had a number of bounce of it.
I can’t be a runner anymore like I used to be where I’m like, “I’m going to go run seven miles.” That used to be, it was my stress outlet. I have found other things that I enjoy just as much and that I get the same mental health benefits and community benefits out of. And at the same time, when I see these people out, it’s 70 degrees outside, gorgeous spring day, and there’s some guy in his little shorts running. You know what I mean?

Jamie Holms:
Yes.

Dr. Andy Roark:
Just running through, I’ll be at the park with my kids and he’s running past the waterfall and just the breeze, and he’s got long hair and a beard. He’s who I never was, but always thought, “Man, if I could grow a beard and run shirtless like the wind, I would be somebody.”

Jamie Holms:
You were that guy.

Dr. Andy Roark:
I would be that guy. But I was never that guy. But anyway, when I see that guy today, it just bugs the hell out of me because I can’t do that. I can’t. I can do it for a little bit, and then my feet are going to explode, and then I’m going to be miserable and it’s not worth it.
So even though there are alternatives that I have found, I work out, I row, I walk, I do all these things that are great. Actually, I hike a lot, do all these things. But boy, when I see that and I go, “I can’t do that,” that really, it still bothers me.
I’ve gotten a lot better at it. I’ve gotten a lot better at it, but it has always been a battle. Well, I’ll take that back. It has gotten to be a battle since I hit 40, six years ago. Sure. Because I was never 23, like, boy, I remember back when I could do those things.

Jamie Holms:
Yes, true.

Dr. Andy Roark:
That’s definitely a later in life experience.

Jamie Holms:
That’s one of the things that I love about you is, you always think that you’re not the right person to talk about something because you’re in the battle, but I can relate to this, so I know our listeners can relate to this.
Let’s backtrack just a little bit and let’s go smaller because you like to dig in.

Dr. Andy Roark:
Okay.

Jamie Holms:
You talk about the importance of differentiating between what we control and what we can’t in this article. I struggle with this sometimes, as you know, where I think I can control things that I can’t. So how do you suggest that we find this distinction, especially in practice?

Dr. Andy Roark:
Yeah. I think one of the greatest challenges in life is figuring out how to differentiate where we have control and where we don’t, I really think. And I think that as you go on in your life, you get better at making that distinction, but I think most of us … It’s this weird pendulum. It’s this yin and the yang.
Because I really do believe, as far as being successful in life and being happy in life, the more that you believe you do have control over your circumstances, I think the happier you’re going to be, in most cases. I think people who say, “Yeah, you know what? I’m going to put a smile on my face. I am going to manifest a good day. I am going to go out and I am going to make the world a better place, and I am going to make other people’s days better,” I think that that is a healthy, really positive, really good place to come from. Most of the most successful people I know, they believe that they can make things happen.
It’s like the professional athletes, the legends, they always wanted to have the ball at the end of the game because they believed that they could make the game change, that they could have this impact. So I do think that we can have that. I think that’s important. But I think the paradox in life is, it’s also, it has its own challenges of taking this ownership, because then, you end up holding yourself accountable for things that you’re not accountable to.
I think that there’s a lot of things in life that are set up paradoxically where the best case scenario is also an uncomfortable scenario, and the more comfortable you try to become, the less comfortable you’re going to be in the long term. So I think taking ownership of our position is that way where it’s like, man, in the short term term, it would be really nice for me to go, “I cannot have power here, so I’m just going to step back and let go.” And over the course of your life, the more you say, “You know what? What agency do I have here? And how do I use that agency?” And insisting that I do have agency.
One of the phrases I heard from a mentor years ago, way back at the beginning of my career, I was working at this big practice and I really did not have any power. I was one of, basically, 30 doctors that were there. And it was a good place, but it was still, everybody chafes, right? And there’s always something that you don’t like. And I forget what the stupid thing was that I didn’t like, but I felt like, I don’t have any agency here because there’s so many voices, there’s so many people here.
So I said to one of my mentors, I was like, “I don’t have any power here.” And he said, “Could you make life worse for the people around you?” And I was like, “Oh, yeah, of course I absolutely could make their life worse, no doubt.” And he was like, “Then, great. Then, you could clearly make their life better. If you could make it worse, you could make it better.” And I was like, “Yeah.” And he was like, “Then, you have agency.”
And that whole idea of, could I make things worse? If the answer is yes, that means I have some agency. And I can use that agency to do good, but for some reason, I don’t know, that just clicked with me as far as coming to believe that I do have this power. Anyway. That’s where I started off with starting to wrestle with what power do we have.

Jamie Holms:
I love that. That’s something that I’m going to use in my life and when I am struggling and be like, “Can I make this situation worse? Why, yes, I can.”

Dr. Andy Roark:
Why, yes, I can. That means I could also-

Jamie Holms:
Of course, I can. Is this a challenge? Sold.

Dr. Andy Roark:
That means I could also make it … Yeah. Exactly. I don’t know why I rise to that, but I’m like, “Oh, buddy, I can get real creative right now. How do make this worse?” I’m like, “I will come up with some weird stuff you have not seen. I will make this worse in ways people have not anticipated.” But why am I not so creative in coming up with ways to make it better? I don’t know, but once I do the “How do I make it worse?” Exercise, it stretches my brain out, like, oh, I do have power here. And then, I can find a positive way, but that was super simple, but that just having it shown to me that way, for whatever reason, it just resonated with me. And so I’m like, “Oh, I do have agency.”
And then, on the flip side, there was another piece of advice I heard much later in my career that rocked me about how little control we have. And the saying is, “There’s three things we don’t control: the past, the future and other people.” And I go, “Oh, man, it seems paradoxical that I can convince myself I do have agency, I do have control, also, not over the past, the future, of other people.”
But I think that it’s this narrowing, right? It’s this narrowing of focus, of understanding where we don’t have control, and then, figuring out the pressure points where we can put our finger and push and make a real difference. And if you’re familiar with pressure points, you know that applying a bit of pressure at a specific area on the human body can cause great pain, it can have great impact on that person. It’s the same thing of, boy, I can only push on these little areas, but if I push on the right area in the right way, I can have a huge impact.
Going back to the jury duty thing, and when you and I were talking about it, he was like, “You have no power in this situation.” And he was right in that I have no power over whether or not I’m put on this jury, over what hours I’m going to be there, over how long these trials are going to go, over whether if I get picked for a jury, 11 people are going to agree, or we’re going to sit there for two days and not agree. I don’t have any power over any of that, but I do have power over how I feel about it and how I behave. And do I go in and have a good attitude about it? Or do I go in and just make myself miserable?
Because one way or another, I’m going to do it. It’s that, when it snows, you got two options. You can be miserable that it snowed, or you’d be happy that it snowed. But either way, you’re still dealing with the snow. I think that there’s a lot of truth to that. I don’t know, does that feel as far as threading that needle?

Jamie Holms:
Man, I love it. It feels so simple to say, “This is how you start getting agency back.” Because I think that’s one of the things that I struggle with is, so many times I hear, “You don’t have control over the situation. You only control how you react to it.” And very often, reaction is a thing that just happens inside of me and I want to respond, and I don’t know how to bridge that gap between reaction and response. And the only thing I know to do is to put distance, space between the thing. And we don’t always have that option, especially at work, and in practice. The phones are ringing, people are walking through the door and you’ve just got to do this. And what a quick thing, just like breathing exercises, is to ask yourself, “Can I make this worse? Great. How can I make it better?” And that’s just so simple.

Dr. Andy Roark:
Hey, guys, I’m going to duck in real quick here and just let you know, I am looking for dynamic duos. I am looking for practice managers and practice owners that love working together, that want to work together more effectively, that want to develop ways of working, that want to develop strategies where they compliment each other. And the reason I’m looking for those people is because we, at Uncharted Veterinary Conference, where I work, have put together a conference for dynamic duos.
We have our Practice Leader Summit. It is in Greenville, South Carolina. It is December 7th through the 9th. This is open only to practice owners and practice managers. Ideally, I’d love for those guys to come together and we are going to have some work separately time and they’re going to have some work together time because, man, that head down, come in together, work on our practice together time is so rare and so valuable.
Anyway. I love it when people come in pairs, but if you’re a practice owner and you say, “I don’t have a practice manager,” or you’re a practice manager and you’re like, “Hey, the practice owner’s not going to be up for it,” or, “I don’t have a practice owner,” you are welcome to come along and you’re going to work with other practice managers and you are going to learn a ton.
Again, Practice Leader Summit, Greenville, South Carolina, December 7th through the 9th. It is a leadership summit. There’s going to be a lot of interactivity, a lot of active work on your practice. I would love to see you there. I’ll put a link to register in the show notes. Guys, let’s get back into this episode.
Well, going to the breathing exercises, you say that, and I’m not a super woo-woo guy, but there is definitely some pieces of woo-woo that I’m like, “It kind of works.” There’s a reason that meditation has been around for 5,000 years.

Jamie Holms:
For sure.

Dr. Andy Roark:
It does work. But the way I think about that stuff is, and I think you’re right, I think one of the real skills that we can acquire, and some people are wired this way where it’s easier for them. They’re naturally geared this way. Other people, it’s a much bigger lift. But I love how you said that, when something happens that’s out of my control, how do I create that space to get my head around it and be like, “I don’t control this, but I got to deal with it, but my control is very limited here.” How do I create that space so I can get a clearer look at it and not feel steamrolled about it, not feel emotional about it, things like that.
I really do think that that is a skill that we can build. And I do think everybody’s got to find their thing. I’ve heard a million people be like, “This is what you do,” and I’m like, “That doesn’t work for me.” And I found other things, I go, “This works,” and I explain it to people and they just, the blank look on their face.

Jamie Holms:
For sure.

Dr. Andy Roark:
But the ability to create space, as you said, I think that is Jedi skill level. It’s the ability, when the phones are ringing, and there’s a client in the room who is angry and you’re going to have to deal with it, and the stupid CBC machine is just spitting out errors for reasons that make no sense at all, can you create some space and say, “What do I control here? And how do I exert my influence in the most productive way possible?” And man, that is really, that’s enlightenment. That is the zen master of vet medicine is, can you do that?
Unfortunately, there’s a lot of tools that help us get space if we have time if we’ve got something that’s nagging at us. I talk, sometimes, I try to be open about this, but I talk about when my wife got cancer last year and boy, I did a lot of walking. I did a lot of gardening. I did a lot of rowing on the rowing machine. I did a lot of stuff that I know helps me. I did a lot of painting. These things that I have found that are like, “Oh, I can get some space here.” This is how I calm things down and get some space and some perspective.
But you have to have a different set of tools for in the moment. For a long time, I did not have those in the moment tools. I still, like everybody, wrestle with them, depending on what’s going on. I got pretty good at those longer term space getters. I was good at going out and finding other things to do and exercise and stress management and stuff like that. But man, those in the moment things, they took a lot of time. I still work on it. I’ve come a long way with getting centered. Some mindfulness stuff, some deep breaths, some … I focus on my knuckles. I don’t know why. I focus on my knuckles.
There’s this basketball coach, this legendary basketball coach, his name, Phil Jackson. And he won 11 NBA titles. He coached Michael Jordan and the Bulls, he coached Kobe Bryant, Shaquille O’Neal with the Lakers, and he’s won like 11 NBA titles. And he’s also a practicing Buddhist, which I think is interesting. He’s an interesting guy. Anyway. I heard him talking one time and he was telling this story about the year 2000’s basketball season.
So he’s coaching in the year 2000. And that’s when, I don’t know if you heard, there was a pandemic. So there was a pandemic and everything shut down. But the NBA was like, “No, we are making money because that’s what we do. We’ve got this pandemic thing.” So they took the entire league and put them in a hotel, basically. Imagine a Disney property, and there’s a basketball court at this place.

Jamie Holms:
What could go wrong?

Dr. Andy Roark:
What could go wrong? Well, they went for it, right? Oh, they were not … You had to test and quarantine to go in.

Jamie Holms:
Oh, my gosh.

Dr. Andy Roark:
So people could not go … These people were separated from their families for the NBA season. It was bonkers. It was a crazy experiment. You should just read about it just to read about it. It’s incredible. But they were like, “We are going for it.” So all the journalists had to stay in. They couldn’t come and go. If you went, they called it the bubble. If you went into the bubble, you were in the bubble. So being in the bubble, according to Phil Jackson, had these really unique psychological challenges for the people who were there and the players. And they’re seeing social media and all these things that are going on and they’re away from their family, so keeping them focused and centered was really hard to get them to play basketball.
It was a simple thing that he did, but he had all of his players, they would all wear rubber bands around their wrists. That was it. And you were supposed to have your rubber band on. So he would get them to wear rubber bands around their wrists. And the reason was so that he could tell them to snap their bands, or if you were working with somebody and you could tell they were zoned out, they were not present in what you were doing, you could reach over and pull their rubber band and let it go so it smacked them. And it was enough of a stimulus that it would focus you back on the moment. This thing smacks on your wrists and you feel that amount a pain, it brings you back to, oh, this is what I’m doing. I’m present.
I never went as far as getting a rubber band for when chaos was going on all around me and I was being swept up in it, but for whatever reason, I would think about that rubber band. And I just found that, if I stop and focus on my breathing, and there’s something about if I just make a fist and look at my knuckles and just focus on them, that’s just my thing and I can get centered and bring my thoughts back to where we are. Anyway. We bring our thoughts back like that. That’s been key for me.
The other thing that I didn’t have in the toolbox when I wrote the article but I find myself doing now, I have found that it’s much easier, when I’m in the moment and things are going crazy, if I can step back for one second and just get a piece of paper and I say, “Great, what questions do I need answers to?” And if I can make a list of the questions I need answers to, that generally helps. It shifts me into a problem solving place that makes some sense it. So, “Why is this person mad? What can I do in this moment to help her feel better? What are the next steps, diagnostically, if the CBC machine doesn’t work?”
And that’s naturally where people’s minds go anyway, but I think a lot of us get stuck. We’re stuck in the stress and we don’t convert it to the action of, this is what I’m going to do next. And for whatever reason, for me, asking those questions, it makes clear my options. Because once I have the questions, I can go, “Great. I don’t have to answer these questions, but what do I need to do to find the answer to these questions? So what are my diagnostic options if the CBC machine continues not to work?” I can huddle up the other doctors real quick and ask and get some insight on that.
I don’t have to know the answer, but I know where I can get the answer. So now, getting that answer becomes an action step of something that I can do and it’s converting that feeling of powerlessness into something that I actually have agency over. And that’s been a tool in my toolbox recently of taking stress, taking chaos, converting it into a list of questions that I need to have answers to. And then, not trying to answer the questions, but grouping them together and saying, “Great. How am I going to get these answers?”
For example, here, let’s just say that I came up with a list of 10 questions I needed answers to. Well, I’m going to huddle the doctors up because I need some advice on what to do if I can’t get my CBC machine working. I’m also looking at my list. I could also ask the group of doctors four other questions that are on this list. And so now suddenly I’m calling a huddle, a doctor huddle, and I’m like, “Guys, I got four questions that I need help with. Bang, bang, bang, bang.” And it’s efficient and it’s fast and I’m getting what I need. And now, I’m back into having active control over the things that I got control over. So that’s just a shortcut that I’ve been using recently that I’ve just found. Again, everybody’s got to find their own thing, but man, that really works for me.

Jamie Holms:
Yeah, I love that. And it takes you from that emotional mindset, right? Because when we’re feeling powerless, that’s an emotion. We’re really wrapped up in that. It changes everything happening in our brain. Our heart is going faster and we’re uncomfortable. And once we get that little piece of control back by switching to that logical mindset by doing some creative problem solving and thinking that through, we’ve switched to that.

Dr. Andy Roark:
Well, I can go from anger or frustration to problem solving. That is a shift I can make. I have never been zen enough, and I probably will never be zen enough, to go from anger to tranquility. I can’t. But I can get around to tranquility if I’m like, “I am frustrated. All right, great. I’m going to switch out. Let’s start problem solving. What are the questions that we have? What are my questions?” And I can make questions while I’m ticked off. I’m like, “Why is this woman the worst?” And it’s helpful. I can get over towards positivity that way, but it’s almost like, if you try to go directly from anger to tranquility, it’s not going to happen. So I go from anger to problem solving, and then try to come back around into solutions. And then, ultimately, you can get to tranquility because you’re actively working on the thing that you’re working on.
I heard some advice one time. Again, I feel like I’m just pulling out different things that people said to me in my life, but for whatever reason, when you hear something that sticks, there’s usually a reason for that.

Jamie Holms:
For sure.

Dr. Andy Roark:
But I had a buddy, and one of his things was, he would say, “Life is what you focus on.” And I always thought that was really important as far as, when you’re in the clinic and there’s just chaos all around you, if you focus on the chaos and believing there’s chaos and being frustrated that there’s chaos, then, your life is chaos. It’s focused on chaos, it’s centered on chaos, it’s anchored to chaos, it’s what it is. But if we can get our head around, I’m going to focus on where I have agency, then, you have an empowered life.
So I can focus on the fact that I didn’t want to go to jury duty, I don’t have time to go to jury duty. Honestly, when I got called for jury duty, my wife had just gotten her breast cancer diagnosis. And I’m like, “Man, are you kidding me?” And that was happening in the background. So I can focus on that and my life can be fear and frustration, or I can say, “You know what? There’s probably some good to this.” Because what ended up happening was, I got called for one trial and it lasted half of one day, and that was it.
And basically, I had a week off at this time that my wife had her diagnosis, and it ended up being this really good thing. But boy, that was not my reception going in. But it just worked out that way. And it could have worked out differently, but life is … What if you focus on optimism? What if you’re like, “I’m going to focus on what’s good and what I can control. I’m going to focus on just being present and doing something different and getting my mind off of things that are going on elsewhere. I’m going to focus on the fact that I’m not in the clinic where things are crazy. I am, instead, just sitting in this jury box listening to someone explain what happened in a traffic accident and just, that’s what I’m doing.” Anyway. Life is what you focus on. I think really that has been really powerful for me.

Jamie Holms:
I agree. I think that’s incredible. When my dad and I were talking about agency, and he was a fire chief in Orange County and he had a lot of things he had no control over, and we talked about how he helped himself find that agency. He said creative problem solving was one of his number ones. And the second I thought was really interesting was that, when he got into that problem solving, that same thing that you’re talking about, that making a list, that it helped him flex his empathy and compassion, and then, that just changed his perspectives.

Dr. Andy Roark:
Oh, interesting.

Jamie Holms:
So that he could go into a situation with the board of supervisors and they were making a decision that maybe it wasn’t the best thing, in his opinion, for public safety. And he could ask himself, “What may make them make these decisions? Or what might they be thinking about? And how can I appeal to them differently?” Or, “What are their concerns? What problems are they trying to solve?”
And I think about that a lot when we go into practice and we’re sitting in there and we’re talking to people and the problem that we’re trying to solve is probably not the problem that they’re trying to solve. And I think about that. I think about that a lot. And how do we get to the place where we find out what problems they’re trying to solve so that we can help them get their agency back? Because I think that’s what’s happening, when they’re so angry, is that they feel like they also have no control in the situation. And how do we give them them some of their own agency back? And I think that’s a gift we can give them.

Dr. Andy Roark:
I really like that. Because empathy is a huge problem solving tool, right?

Jamie Holms:
Absolutely.

Dr. Andy Roark:
We talk about dealing with angry people, we talk about working with the staff, working with teams, trying to assume good intent on the part of others. All of these things are skills that we know are effective, and that, on our best days, we say, “Yes, this is how I handle this angry client.” So if I said, “Hey, what are the steps for dealing with this angry person?” I’m sure I’d get a list of wonderful things from everybody involved.
But of course, you say, “I’m going to try to hear this person. I’m going to try to assume good intent from this person. I’m going to remember that everyone’s fighting a battle we don’t know anything about. I’m going to try to empathize and sympathize,” and all of those things. So if I can get from frustration into problem solving, and then, problem solving says, “Okay, what are our tools to handle this?,” that gets me into empathy, assuming good intent. That’s how I come back around to tranquility. That’s beautiful, Jamie.
Hey, thanks so much for pushing to get together to talk about this.

Jamie Holms:
I love it.

Dr. Andy Roark:
I really appreciate you.

Jamie Holms:
This is great.

Dr. Andy Roark:
Thank you for doing this with me.

Jamie Holms:
Totally.

Dr. Andy Roark:
This is such good timing. I just had this conversation with my dad. I love it.

Jamie Holms:
Oh, thanks a lot. Awesome. Well, thanks to everybody for listening. Take care of yourselves, everybody.

Dr. Andy Roark:
Bye. And that’s it. That’s what I got for you guys. I hope you enjoyed it. Thanks to Jamie for being here. As always, if you enjoyed the episode, please do me a favor and leave me an honest review wherever you get your podcasts, or share the episode with your friends.
That’s how people find us, those two ways. Anyway, that’s what it’s all about. I want to help as many people as possible, and I need you guys to spread the word and let people know that we’re over here doing it. Otherwise, I feel like I’m just talking into the void, sometimes. But then, people come up and say, “Hey, you said this thing was really helpful,” and it all is worth it again. Anyway, that’s all I ask. That’s it. Anyway. Okay. Take care of yourselves. Be well. I’ll talk to you later on.

In January, Dr. Cassi Fleming (of the Vetfolio Voice Podcast) interviewed Dr. Andy Roark on lessons he has learned in his strange and wonderful career. That episode of Vetfolio Voice is presented here.

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

LINKS

Vetfolio Voice Podcast: https://www.vetfolio.com/pages/podcast-landing-page

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

EPISODE TRANSCRIPT

Dr. Andy Roark:
Welcome everybody to a bonus episode of VetFolio Voice. That’s right. This is not The Cone of Shame Veterinary Podcast. I mean, it is. It’s coming through The Cone of Shame channel, but this is an episode of another podcast called VetFolio Voice that is hosted by my friend, Dr. Cassie Fleming. She is amazing.
If you don’t know her, she invited me at the VMX Conference to come to the VetFolio booth and to be interviewed on a podcast for her. And then, when it was over, she said, “Would you like to have the audio and you can put it out as a Cone of Shame episode if you like?” I really loved our conversation. I thought it was really great, and so she generously passed the audio over. And so, I want you guys to check it out.
But if you like this conversation, check out VetFolio Voice. Check out what Dr. Cassie’s doing. She’s really great, but they have lots of other people much smarter and more interesting than me probably doing interviews. Anyway, guys. Thanks to VetFolio Voice for letting me share this with you guys. I hope you’ll check out their other episodes of the podcast. 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. Cassi Fleming:
Well, thanks everybody for tuning in. I’m sitting here on the expo hall floor at VMX with the one and only Andy Roark, so thank you for joining me.

Dr. Andy Roark:
No. Thanks for having me. I appreciate it.

Dr. Cassi Fleming:
I’m happy to have you and to bring your messaging out to the audience. Not that you need any help with that, because your messaging is far and wide and for a reason. You have so many good things to say.

Dr. Andy Roark:
Well, thank you.

Dr. Cassi Fleming:
I’m excited to sit down and talk to you and pick your brain a little bit.

Dr. Andy Roark:
Sure. Fire away. Whatever you want to talk about.

Dr. Cassi Fleming:
I guess we can start with a little bit of the backstory of how we got introduced. It was me reaching out through Facebook, wondering if I was still a real vet, because I was going through some career changes and taking on a less clinical role.
I was really struggling emotionally with that, to go, “Am I still a real vet? I don’t know. Am I a sellout? What am I? What’s happening here?” You and I had a great conversation and I felt so much better after our talk.

Dr. Andy Roark:
Well, that’s good.

Dr. Cassi Fleming:
I’m wondering if we can bring a little bit of that to everybody listening?

Dr. Andy Roark:
Sure. I do remember that email when it came in, but I think everybody has to find what works for them. It’s kind of like with therapy. We’re like, “There’s no right answer.” It’s the tools that you need to process and feel good about where you are. And so, self-identity is a big part of it. I think self-identity is a big part of vet medicine. The way we see ourselves really matters.
It’s why vets get so mad when pet owners will say stuff like, “You’re only in this for the money.” We say that because it’s a challenge to our core identity and who we are as people. We know it’s garbage. We know it’s not true, but it’s so much being giving and supportive and helpful and doing everything we can, and so much a part of how we see ourselves. When somebody says that … Again, it doesn’t hit everybody that way, but there’s a lot of us who really react emotionally very strongly to it.
But I think it’s really because it hits that identity thing. And so, there’s very much a strong culture in vet medicine that I love. You guys, you see. I was just talking to some technicians outside the booth. They work in industry now, but I knew who they were as soon as I saw them. You can tell by the way they walk that they’re technicians. They’re credentialed technicians. They’ve been in the trenches. You just talk to them for a minute and you know that they have seen some stuff and they’ve done some stuff.
They can’t hide it. It’s baked into who they are. That’s the type of culture that we have. It kind of permeates you as a person after a while. And so, it makes a lot of sense that as you go on in your career and you start to do other things … Especially, as a doctor, when you’re not just in the exam rooms, putting hands on patients and fixing patients. At some point, you start to say, “What does this mean for my identity? What does it mean for who I am?”
And so, there’s this thing called cognitive dissonance. Cognitive dissonance is this idea … If I’m not living a life that matches up with the ideal version of myself in my head, I don’t like that. We want to believe that we’re being the person that we want to be. I see cognitive dissonance a lot in doctors that start to do other things. Whether it’s moving to industry. Whether it’s to start doing other careers. Whether it’s going part-time, so they can spend more time with their family. Whether it is moving up into management leadership roles, which is more and more common.
As we have corporatization, we have a lot more doctors that are getting bumped up to be a chief of staff at a hospital, a medical director, something like that. Now, we’ve got more and more doctors that are stronger leaders that are moving up into overseeing multiple hospitals. These are roles that just didn’t exist in the past. And so, there’s a lot of doctors moving up into those spots and they’re really having an identity crisis in a lot of ways. Because they’re like, “Man, the ideal version of me is in the exam room. Helping people, fixing pets, helping pet owners. Making an impact there.”
I’m the person who my technicians say, “We’re really behind,” I can step in. I can fix things. “I can’t get this catheter in.” I can step in and do that. Whatever. I say that as a total joke, because my technicians are never going to ask me to put a catheter in. Because they’re exponentially better than I am. But the idea is as we’re not doing those anymore, we have this weird thing of, “Who am I and what am I?” And if you hold yourself to the standard of, “I am great because I’m excellent in the exam room. Clients like me and I get Thank You notes.” And then, you’re not in the exam room anymore and you’re not getting that validation. You’re not getting Thank You notes, because you’re not in the exam room you used to be.
You’re like, “I’m failing. The thing that I thought made me good, I’m no longer doing. And so, I’m failing.” There’s a lot of pain that I see people are carrying around from this identity. I kind of went through that as well. I very much had this imposter syndrome as I do more and more things that I do. I own Uncharted Veterinary Conference and I run this business conference and this online community for vet leaders. It’s very much a leadership development platform.
And so, as I do that and I do more and more speaking and I do writing and stuff … I still practice, but not in a significant way like I used to. Every week, I’m in the clinic, but it’s one day and that’s it. You start to look at yourself and you’re like, “I don’t like the idea that I’m pretending that I’m a full-time veterinarian.” I don’t want people to see that. I don’t like to live my life in this idea that I’m misleading people about who I am. I want to have that confidence.
I heard this interview with a Hollywood agent one time. She said, “Powerful people don’t wear toupees.” And that’s what she said. The idea is that a toupee is something that someone wears because they’re insecure about the way they look. Something like that. You’ve got a guy and he’s bald and he’s going to wear a toupee. She said, “The thing is that people know and they’ve got something on you.” You are trying to fool them. You are showing that you are insecure about this thing and you’re putting it forward and people know. They feel like they’ve got something on you.
I don’t mean this in a bad way at all, but the idea is she says powerful people don’t wear toupees. The idea is that if you are powerful, you don’t care. You’re not going to give someone that leverage or that ability. You are who you are and you have that confidence. Again, I’m not trying to make this a reference about toupees at all, but it was an interesting way of putting it. She looked at it and I’m kind of like, “Man, I feel like I’m wearing this veterinary toupee.” In a way of, I’m not in practice all the time and I feel like I’m worried about people knowing that. And that doesn’t make any sense.
And that’s not how I want to live my life. It’s not an authentic version of myself. And so, I don’t think anybody cares, but I care. I’m talking about my self-identity and sorting these things out. Ultimately, it comes all the way back around to … Basically, I got comfortable with the idea of not being a quote, unquote, “Real vet.” I was like, look, I’m a guy. I’m a writer and a speaker and I practice. I’m a dad and I practice.
I think we have a problem in vet medicine in a lot of ways of just having our identity so wrapped up in our job. I think there’s something really healthy in being able to say, “It’s just a job. It’s not who I am.” I go to work and I do the thing and I go home and I put it down. I have other hobbies and I do other things and I engage with my family. When we talk about burnout and mental health and stuff like that in vet medicine, I think this idea of, “Being a veterinarian defines my core being.” I don’t know that that’s really healthy.
My mental shift was to say, I’m not going to ask myself if I’m a real vet or not. I am a dad who practices. I am a writer who sees cases. That’s what I do. That’s who I am. And that’s not cognitive dissonance for me, because that is who I am. The authentic version of myself and how I see it. And so, when I talked to leaders who have, say, moved up and they’re managing people now instead of seeing appointments. A lot of them go, “But am I a real vet?” I was like, “Well, there’s two options.”
You can either try to talk yourself around into the idea that, “Yes, I am a real vet, because this is what being a real vet means.” And so, you can go through the process of defining what is a real vet in your mind. Or you can let that go and just say, “I am a leader of people who also sees appointments when it’s needed,” and decide to be okay with that. But anyway, that was the process that I went through.

Dr. Cassi Fleming:
Well, I’m listening to you talk and I relate so closely to everything that you’re saying. All of those emotions I can identify with. I agree with you about having it baked into your identity like you put it. In that, it is a reality. I don’t know if it’s healthy, but I know it’s part of me.

Dr. Andy Roark:
It is what it is. Sure.

Dr. Cassi Fleming:
I can certainly feel that way.

Dr. Andy Roark:
Well, of course. Think about the process it takes to become a vet. You go through four years of vet school. Vet school is hard. It’s really hard. I’ll never forget one of my buddies that was in vet school.
At one point, it was one in the morning and we’re in the library and we’re studying. He looked at me and he said, “Honestly. Did you think vet school was going to be this hard?” I was like, “No. I 100% did not think it was going to be this hard.” I was like, “Yeah. It’s a thing. I’ll go. It’s like a program.”

Dr. Cassi Fleming:
I’ve done school my whole life.

Dr. Andy Roark:
I’ve done a lot of school. I had no idea how hard vet school would be. I’m still blown away at how difficult it was, but it was this crucible in a lot of ways. When you go through something like that, it does become an identity. You see people who are wild college fans. They went to the school and now they have all the accoutrement.

Dr. Cassi Fleming:
I was Florida Gators.

Dr. Andy Roark:
Florida Gators, all the way. I know. Exactly. But vet school is that turned up nine notches. It’s the same thing. People celebrate it because they had this experience. They in incorporate this experience into their identity. But man, that’s nothing compared to vet medicine. When you’re like, “Boy. The training process is so rigorous and so grueling.” And then, I punch in and punch out every single day and what we do is emotionally challenging work.
It is a very difficult job. It’s a great job, but it’s a difficult job. And so, all of those things are like you carry those scars, those experiences. And of course, they kind of bake into how you see yourself. I think it’s undeniable. It’s going to happen. I think so much it may be an unreasonable goal to say, “I’m going to think this is just a job and still be happy.”
I think it’s probably one of those things in life that’s good to aspire to, because you’re never going to do it, but by trying to get there, you’re putting yourself into a healthy space. Do you know what I mean? I don’t even know that … I think if you’re like, “I don’t see it as a job, so I’m failing.” I think that’s wrong. I think that you should aspire to see it as a job. And then, when you come up short, you’re probably where you need to be.

Dr. Cassi Fleming:
You’re probably where a lot of us are. For all of us.

Dr. Andy Roark:
Hopefully.

Dr. Cassi Fleming:
Well, I like that you brought up the cognitive dissonance. There’s this internal monologue that we’re all trying to figure out, but listening to you talk about it and thinking about it from my own perspective, I’m like, “Oh my gosh. I think I’m putting all of this energy into how I describe what I do to other people.”

Dr. Andy Roark:
Yes.

Dr. Cassi Fleming:
That is where the rub is. In the grand scheme of things, is it really that important how I describe my job to other people who ask me?

Dr. Andy Roark:
It’s interesting. For most people, the answer is a solid no. There are other vets that will 100% look at you like, “But do you practice?”

Dr. Cassi Fleming:
Right.

Dr. Andy Roark:
You see it. I just remember people over the years always asked me, “But how much do you practice?” It’s interesting. Because in their mind, that’s the value system that they have, which is you’re a vet, which is defined at how many hours a week you’re in practice, seeing patients, and putting your hands on them. And that’s how they associate what you’re doing.
I think that when you’re being asked that question, it feels like a judgment question of, “What is your worth?” I don’t think that people mean it that way. I think they genuinely want to understand, “What do you do with your time?”

Dr. Cassi Fleming:
Sure.

Dr. Andy Roark:
And so, I think that the way that you receive that question is probably different from how it’s intended. Although there are some people who definitely have that measuring stick out. What I would say is it’s a stupid measuring stick.

Dr. Cassi Fleming:
There you go. Is that really a healthy measuring?

Dr. Andy Roark:
Exactly right. Exactly right. But how many hours do you spend in the exam room? I’m like, “What does that have to do with anything, really?” You know what I mean? If you want to understand …

Dr. Cassi Fleming:
It’s better if you’re in medicine. It’s so far and wide. There’s so much more to it.

Dr. Andy Roark:
Well, if you want to understand how I spend my time, then I totally get it. If the idea is, “We’re going to compare ourselves as individuals to each other based on the number of hours we spend in the exam room,” that’s just not a contest that I’m particularly interested in. But I do think that part of the growth is deciding that you’re not interested in that contest.
If you think that contest is important, then the measuring is a big deal for you and always will be a big deal for you. But I think what’s liberating is to say, “This is not a contest I want to win.” It’s kind of like if you step back and you look at … I think most of us go through this in life. We came to vet medicine and we did not come here for riches.
At some point in this world, we’ve got this very visual society and people are on social media and we see how other people live their lives. We’re seeing the best versions of themselves in the front stage and their vacations and stuff. At some point, you have to kind of decide, “Well, what does it mean to have a happy life?” I think most of us at some point figured out, “I’m not going to measure the quality of my life by the money that I make or by the material possessions that I have.”
I think this is just another extension of that. We’re always deciding how we’re going to measure the quality of our life. And so, there’s just a lot of us who measure the quality of our life by the number of hours we spend in the exam room helping pets. And that’s not a bad measurement, but I wouldn’t compare people with that measurement. And I choose not to value myself based on that measurement.

Dr. Cassi Fleming:
I feel like you’re speaking to my soul here. Because spoiler alert, I did increase my time in industry and it was hard.

Dr. Andy Roark:
Sure.

Dr. Cassi Fleming:
I struggled a lot emotionally. Probably, because of that measuring stick we’re talking about. But at some point, I looked around and I was like, “I’m really happy with the situation that I have here.” And I’m the same as you. I still practice and still practice a lot.
It did become this … I became comfortable talking to people about what I do and saying I’m in continuing education. I think you actually helped me craft some of that wording of, “This is what you do. This is what you’re doing.” It helped put a label on it. It helped me recognize the importance of it. And then, I woke up one day and exactly like you’re describing. That measuring stick didn’t matter anymore.

Dr. Andy Roark:
That’s what it’s got to be.

Dr. Cassi Fleming:
I feel good.

Dr. Andy Roark:
“I’m in continuing education and I practice veterinary medicine.” That’s great. That’s an accurate representation of who you are. Also, when you use that language, it’s you verbalizing the measuring stick that has chosen to matter to you. Everybody should have a measuring stick.

Dr. Cassi Fleming:
I was going to say. Should we have these measuring sticks? Are these important?

Dr. Andy Roark:
You should. You should, but you should be extremely intentional about which measuring stick you choose. Because your life is what you focus on. And so, if you focus on the fact that, “I’m not in the clinic as much as I want to be or as much as I used to be,” then your life is one of you coming up short. And that’s how your life is. If you focus on politics and you’re like, “I eat, breathe, and sleep politics, then your life is politics and conflict.
Your life is this thing that’s going on that you really have very little or no influence in, and that’s your life. This thing that you don’t have any influence over. Again, I’m not saying, “Ignore this or do that,” but I am saying you should be intentional about what you focus on. It’s a subtle shift. But if you say, “I’m going to measure myself based on the number of appointments that I see,” and I switch that over to, “I’m going to measure my life based on the impact I have in my community.” Those are different measuring sticks.

Dr. Cassi Fleming:
Very.

Dr. Andy Roark:
But I don’t think that one is necessarily better than the other. But I think that you can select a measuring stick that matches what you’re doing and who you are, and I think you can be much more happy. Ultimately, you have to decide what’s important so you can live your life to it, but you should be really intentional about how you make that selection.

Dr. Cassi Fleming:
I like your focus on intentionality there. I think that is something that’s really difficult, because it is so easy to define yourself as a veterinarian by exam room time. And then, when you get away from that, all of a sudden you’re like a ship without a rudder. Where am I? Who am I? What am I doing?
Not just letting it all come together and figure it out along the way, but seeing it clearly. I like what you said about being intentional. About how you craft that messaging to yourself even more importantly than other people.

Dr. Andy Roark:
Absolutely. Veteran medicine, it’s intoxicating that way. In that, there are so many things that we can quantify in medicine. I think most of us look around and try to figure out, “Is our life meaningful?” Or, “Are we living the purpose that we want?” We always want to know how we’re doing. Honestly, I don’t know how much of it is bred into us versus how much is trained into us.
I promise you. It is definitely trained into us. We go through vet school and everybody’s trying to get an A and everything is quantified. What did you get on this exam? What did you get in this course? Do you get a gold star? Do you get a pat on the back? We are brought up into that system. Then, you get out and I see a lot of that really struggle with the end of the pat on the head, A-plus system. And so, they look for another way to pat themselves on the head or get the A-plus or get the gold star.
Vet medicine offers a lot of things that are very quantifiable. How many appointments did you see today? How many patients did you see? How many Thank You notes did you get? Did people mention you in online reviews? What is your Google rating? What is your practice’s Google rating? Are you doing this other thing? Are you certified in this thing or that thing? There’s all of these little gold stars and metrics and numbers that you can put on and say, “How am I doing? How am I doing? How am I doing?”
The thing that’s hard to put a number on is how you’re going to feel at the end of your days. You know what I mean? When you look back on your life and say, “Did I live a good life?” I think a lot of us would really like to be able to get a report card that tells us how we did. Because a lot of us came up in that system and we’re like, “I’ve always gotten As. I’m going to get an A in life.”

Dr. Cassi Fleming:
How else will I know?

Dr. Andy Roark:
How else will I know? But there is no report card that comes at the end. You know what I mean? You don’t get a grade on the quality of your relationship you have with your kids. You know what I mean? You don’t get a grade based on who you affected and how you helped other people in their lives. It’s not quantifiable. And I think that’s a challenge. I think it’s really easy to try to look at numbers and say, “How am I doing? How am I doing?” And so, it’s not an easy issue.

Dr. Cassi Fleming:
It’s kind of an internal evaluation there.

Dr. Andy Roark:
It’s absolutely an internal thing.

Dr. Cassi Fleming:
And that’s because things are so externally quantifiable and there’s so much data to say how we’re doing. At least, professionally. Maybe it makes it harder to look internally and find that internal validation?

Dr. Andy Roark:
Of course, it is. I really struggle with this. Again, you write the book you need to read. I really struggle with validating myself. It was funny. I was talking to somebody recently. I’m a big believer in positive reinforcement. I really am. My staff that I work with, I really want them to know how much I appreciate them. I really focus a lot more on trying to catch people do doing good work and calling it out. As opposed to saying, “Well, this didn’t really go well.” Or, “We could do that better.”
I’d much rather catch them when they crush it and just say, “Did you see that? Did you see how that worked? Did you see how great that was? Let’s do that again, because that was amazing.” It’s a better way to grow people and to make them want to work for you. But the truth is, I don’t tend to use that with myself very much. I’m very problem-focused. I’m that guy who I could do a surgery and it would be great. And I will say, “That incision could have been smaller.” That’s exactly it.

Dr. Cassi Fleming:
Did I put in that suture in the right spot? Did I put an extra one in that I shouldn’t have?

Dr. Andy Roark:
It’s pooching out at the bottom.

Dr. Cassi Fleming:
Yes. The dog ears. I can’t.

Dr. Andy Roark:
Exactly. It’s a thing we all kind of have to work on. I think a lot of things that make you great in your profession as a veterinarian or as anything else … Most all of the things that make you great are also double-edged swords. Your attention to detail is going to torture you. In that, you can’t control everything and it’ll always be wrong.
Your perfectionism is going to make you wonderful in working up cases, and it’s going to punish you, because you’re going to really struggle to delegate. Because other people won’t do it the way that you do. I don’t know. Your charisma is great, because it makes people want to be around you. And it also makes it really hard to get out of exam rooms. It slows you down.

Dr. Cassi Fleming:
I feel that.

Dr. Andy Roark:
But it’s almost all that way. It’s really interesting. I didn’t realize earlier in my life how much our real strengths are almost always weaknesses on the other side. We really have to manage our strengths or else they’ll eat us up.

Dr. Cassi Fleming:
I never really thought about it. You always think about it from the contrary perspective of, “My greatest weakness actually is my greatest strength,” and all this. But you’re right. It goes the other way. My strength is my weakness as well. I remember right before my vet school interview having a conversation with a friend of mine, who was helping me prep for the interview.
I was working as a technician at the time and I said, “I’m pulling my hair out and I can’t keep up with all of these things.” He said, “Well, don’t you have other people that you work with?” I said, “Well, yeah, but the manager pulled me aside and she said ultimately what happens on the floor is my responsibility at the end of the night. So I have to go and I have to make sure everything is right. Because otherwise, it’s going to come back on me.”
He said, “Well, don’t you trust the people you work with?” I said, “Of course I do.” He’s like, “Well then, why are you having to go back and check and double-check?” And so, what you said there about being a really bad delegator I feel is something that I can identify with very closely. I certainly feel the perfectionist and detail-oriented tendencies in myself. Just because I think we’re all a little bit that way. I don’t think my husband would agree.

Dr. Andy Roark:
Sure. And it’s on the flip side as well. One of my strengths is delegation. I tend to leverage people really as well. I’m such a big technician fan. That’s because I like techs and I like working with techs. They make me so much faster and better, because I’m very comfortable delegating to them. But there’s a flip side to that sword as well, which is I will empower people and sometimes they’ll struggle.
Because I empower them, but they don’t have as much support as they would like. I have to manage that of, “I’m very willing to give you this thing. I’m giving you an opportunity here.” But sometimes, I delegate these things away. And there’s a chance I’m going to have to go back and say, “This didn’t work out the way that we wanted.” Or “Hey. I didn’t realize that you hadn’t been trained in this,” and things like that.
But there’s no perfect way. You’re going to fail on one side or the other. You’re either not going to give people opportunities, you’re not going to give them autonomy, or you’re giving them autonomy and they’re going to make mistakes.

Dr. Cassi Fleming:
Sure.

Dr. Andy Roark:
And so, you pick your poison. That’s another part of life. We’re always just picking our poison. The Buddhists say that life is suffering. And that seems really awful and morbid, but I think it’s true in a lot of ways. I think that that life is always going to be hard. You should just know it’s always going to be hard.
The greatest empowerment we have is choosing how you’re going to struggle, because you’re going to struggle. Do you want to struggle by holding onto everything so it gets done the right way? Or do you want to struggle by giving it away to people? And then, you have to check back up on them, and every now and then, we have to make some adjustments. There’s no way that doesn’t have some hardship in it. It’s choosing the hardship that you have.

Dr. Cassi Fleming:
I’ve heard the Buddhist saying, “Life is suffering.” I think that’s good life advice to say, like you said, life is going to be hard no matter what. How would you apply that to vet med? In some ways, vet med is hard. It’s always going to be hard.

Dr. Andy Roark:
In some ways. That’s exactly it. People talk a lot about the hardships of the profession. I’m really glad you asked me this, because I think this is really important. Vet medicine ins always going to be hard. It is a hard job. It is a emotionally taxing job. It’s a mentally taxing job. It is a hard job. You get to choose how you suffer in this life and how you struggle.
And so, here is the question. Do you want to struggle having a hard job that people get really upset about? There’s people who have strong emotional feelings about their pets and how their pets are treated. You are going to deal with people who are having the worst days of their life. You’re going to deal with high-stake situations. You’re going to deal with death, but you’re going to do work that matters. Do you want to struggle and suffer that way?
Or do you want to have a job that nobody cares whether or not you actually make the widget? No one’s ever going to know whether or not you showed up for your shift in whatever big warehouse. That’s suffering as well. Because you’re doing work that doesn’t matter. Or you’re doing work that nobody cares about. Or they don’t care very much about.
There’s not a right answer and there’s not a wrong answer. I’m not trying to crap on anybody’s job. But at some point, we chose a hard job. And the alternative is choose a not hard job or a not important job. Or a job that does not affect other people in the deep way that we affect pet owners. And that’s your choice.

Dr. Cassi Fleming:
For me, I think it depends on the day, which way I want to suffer. For the resounding majority of the time, I love doing the work that matters. But I definitely have my days that I wake up and I would rather go make widgets.

Dr. Andy Roark:
Sure. Of course. I think there’s truth to that as well. Life comes in waves, in phases. I’m not a big believer in the phrase of, “Work-life balance.” I don’t like that. When people say work-life balance, I imagine that I’m supposed to sleep for eight hours, I’m supposed to work for eight hours. I’m supposed to be detached with my family for eight hours.

Dr. Cassi Fleming:
Sure.

Dr. Andy Roark:
That’s too many hours. No, that’s right. All right. Cool. But that’s how it’s broken up. You do this and you do this. My life has never worked that way. Everything has bled over into other things. I think that’s how it is.

Dr. Cassi Fleming:
I think I hear you talk about work-life integration?

Dr. Andy Roark:
Yes. It is very much starting to think about what kind of life do you want to have and how does it work. My big thing when I look at work life integration is your life is complicated and there’s no balance. It doesn’t work that way. But the way that it looks like for me is there’s tides. Think of ocean tides. You have high tides and low tides and they come in phases. And that’s just been how my life has always worked.
I can’t comment on other people’s lives, but mine is for sure. Sometimes there are high tides. What that means is we’re working all the time. And sometimes it’s low tides and we get to relax. Remember when you went to vet school and you got your butt kicked in the first year? That’s high tide. Remember your first year if you did an internship? Or your first year as a new vet? That’s high tide.
When you’re three or four years in, perhaps you’re going to organize your life and say, “Hey. I’m comfortable now. I’ve got a number of years of experience. I’m going to take this year and just practice and not push myself to new things.” Or maybe you say, “Hey. I’ve been out five years. I’m going to buy this vet practice and it’s going to be a huge …” That’s a high tide. We don’t always get to choose when our high tides and low tides are. But I think that’s really important. You should always pay attention to that.
Yes. You’re not going to feel every day, “This is how I’m going to suffer. This is what I want to do. I’m going to keep the pedal to the metal.” I don’t think that’s sustainable either. But I think there’s times in our lives. I’m not talking about three hours. I’m not talking about three weeks. I’m talking about a year where you’re going to lean in and you’re going to work and this is going to be kind of a burden that you’re going to carry.
And then, hopefully, you’re going to set your life up so that you have some time to lean back a little bit and maybe have a low tide. When things kind of roll along in a more organized, less stressful way. But anyway, that’s how it’s been for me. Things go well in six months. I’m kind of laid back. And then, a year, I’ll work really hard.
And then, another year, you say, “Well, I’ve figured some things out. I’ve got a good job. I’m comfortable here. I’m just going to kind of do this and live my life.” And then, something else will come along and the tide will rise again. I can handle stressful times. And I’m okay with feeling, “God. I’m working all the time,” as long as I believe there’s a path ahead. I’m going somewhere.

Dr. Cassi Fleming:
Right. There’s a light at the end of the tunnel.

Dr. Andy Roark:
Exactly. If you’re working and you’re like, “I’m working all the time and there’s no way out for me. I do not see this changing,” I think that’s a really dark place to be. If you’re saying, “I’m working really hard right now, because I’m onboarding new assistants and front desk staff.” You go, “God, I’m working so hard,” but you’re going to get them onboarded.
You’re going to get them trained. And then, you’re going to be able to step back and breathe a little bit. That’s a much happier, friendlier place than, “I’m working really hard and this is my life forever.” I think that when people find themselves mentally in that second place, that’s a dark place that a lot of people are.

Dr. Cassi Fleming:
That’s where we start to go to burnout.

Dr. Andy Roark:
Exactly. That’s where we start to get a burnout. Anyway, there are adjustments we can make if you get into that place. When we talk about people working hard, burnout is not about working hard. Burnout is about looking ahead at the future and what you see. There’s this book called … I think it’s called Lone Survivor. So it’s an army book. Mark Wahlberg was in a movie called Lone Survivor.
Anyway, in the book it’s interesting, because this guy’s true story of his life. He’s a Navy SEAL and he talks about the Navy SEAL training. And so, they go through this really intense crazy training. It’s like 10 weeks long. Basically, the last week, they call it Hell Week and it’s just awful. You don’t sleep for a week and it’s just complete brutality.

Dr. Cassi Fleming:
Oh my gosh.

Dr. Andy Roark:
He tells his story and what happens is they go through nine weeks of grueling training and they get to the 10th week, which is Hell Week. They have this bell. And if you ring the bell, it means you quit and you drop out of the training. And so, they’re always trying to get people to ring the bell, because they want them to drop out. So that only the best of the best of the best get through this thing.
Anyway, the guy tells the story about how on the first day of Hell Week, more people rang that bell than had rang it in the previous nine weeks. Later on, he was talking to one of the instructors and he said, “That was really weird. Because here we were and it was the first day of Hell Week. We have had harder days. Absolutely, had harder days than the first day of Hell Week, but all these guys dropped out on the first day of Hell Week. Why is that?”
The instructor said, “Because it’s not the day that broke them. It’s the knowledge that there are six more days ahead. That’s what broke them.” And that’s the same thing in vet medicine, where there’s not a hard day that’s going to break you. But if you believe that there’s nothing but hard days ahead, that’s what drags you down and holds you there. And so, it’s really not about that, “What I did today.” It’s about the idea that there’s not a light at the end of the tunnel that I’m going towards.
If you’re looking at your life and you’re looking at your career, I need you to believe that things are going to get better. I need you to see the light at the end of the tunnel. Even if you have to make that light. Even if it’s, “I’m going to do this for three months.” And if they’re not able to hire more people to help me, I am going to go and tell them, “Hey. I am changing my work schedule, because I can’t keep this up.”
Or in three months, if they don’t have some help, I’m going to leave. You go, “That’s awful.” I go, “It’s not awful.” It’s me being honest about what I’m capable of and what’s possible. Remember, at some point, I think the biggest lesson that veterinarians need to learn right now is you need to look in the mirror and you need to start to think about capacity.
Your capacity is your ability to actually do work. How much can you handle? Your desire to help people cannot outshine your capacity. It can’t. Not in a ongoing way. There are some days that I give more than I have. I suck it up and I grip my teeth and I do it. I can’t do that for a year.

Dr. Cassi Fleming:
Right.

Dr. Andy Roark:
I can do it for a day. I can do it maybe for a week. Maybe three weeks. I can’t live my life this way. That’s just how it is. At some point, you have to believe that you can’t pour from an empty cup. You can’t feed from an empty pantry. If you don’t have it to give, you can’t give it. And so, the question then is, “What is your goal?” What is your measuring stick?
What happens is a lot of people get the wrong measuring stick in their mind. They say, “How much good can I do today?” And that’s the measuring stick they have. And that’s the wrong measuring stick. The right measuring stick is, “How much good can I do in my career?” And that’s really important.
Because if you give of yourself and you give of yourself and you give of yourself and you burn out and you leave the profession in four years … The amount of good you did is tiny compared to had you set some boundaries and you worked for 30 years, because you didn’t burn out.
The overall amount of good that you do is significantly greater by you saying, “No.” Setting some boundaries. Deciding, “This is what I’m able to do. I’m sorry. This is all I have to give.” Keeping that in a sustainable way. Too many of us, we help ourselves out of the profession and that’s a problem.

Dr. Cassi Fleming:
I feel you’re in my head right now. For some reason, I feel like every time we talk you say exactly what I need to hear. This is no exception. Because I’ve been in both of those spots. I’ve been in a clinical capacity where I’m like, “This is never going to get any better.”
But then, take it on the flip side. I’ve talked about my mobile practice on the podcast before and I’ve been working really hard on it lately. Really hard. And it has to do with clients, but a lot of it has to do with paperwork and automations and all of these different things. It’s been a lot. To the point where I’m like, “I don’t know how much longer I can keep this up,” but there is that light at the end of the tunnel.

Dr. Andy Roark:
There’s got to be.

Dr. Cassi Fleming:
There is that to finish it. It’s a totally different feeling dealing with that than it is that clinical, “This is never going to get any better.” I say clinical, because that’s what the experience was for me.

Dr. Andy Roark:
Sure.

Dr. Cassi Fleming:
Talking about that work-life integration, it made me think about my kids. One of the things I like to talk about is walking that line as a parent. I want to be the mom for my kids that’s there for what they need.

Dr. Andy Roark:
Sure.

Dr. Cassi Fleming:
I want to show up to their games and their concerts and whatever they have going on and make sure that they can live this full happy childhood. But at the same time, I also want to be this good example of … I’m speaking from a woman’s perspective of this person who goes and I have goals and I have aspirations and I work hard and I attain them. Man, it is such a balancing act. Your high tide and low tide example, I was like, “I identify with that a lot.”

Dr. Andy Roark:
Totally. High tide is dance season. When your kid is on three dance teams and they do this thing, but it’s a season. Some people are like, “That’s my whole life.” I go, “We need to talk about capacity.”

Dr. Cassi Fleming:
Yes. Yes.

Dr. Andy Roark:
But if you’re like, “This is what we do. We’ve got Monday, Wednesday, and Friday dance. It’s three months out of the year,” or whatever. You decide this is important. Let’s high tide. We’re going to buckle down. We’re going to pull together as a family.
We’re going to talk about logistics and how we get this thing done. We’re going to do some time management. We’re going to do it with the idea that we’re going to do this. And then, we’re going to step back and, “Kids. You can do something else, but it’s going to be one night a week.”

Dr. Cassi Fleming:
There you go.

Dr. Andy Roark:
After that. That’s exactly what I’m talking about as far as high tides and low tides. It may not be possible to say two nights a week per kid per activity in perpetuity. That’s what happens. No. Sometimes it’s five nights a week for a couple of months. And then, we go down to one night a week.
But my big thing is you need to intentionally go back down to one night a week and say, “This is low tide.” Intentionally. And then, in three months, six months, or whatever, we’re going to step back up and this new thing is going to start. We’re going to pick it back up from there.

Dr. Cassi Fleming:
Also, taking turns like, “It’s dance season, so we’re going to do Monday, Wednesday, Friday.” And then, we’re going to have competitions on the weekend and we’re going to travel. And then, end that.
Okay. I’ve put some of the work aside, because I’ve really tried to focus on this and be present for this. Well, now I need to focus here a little bit more and I need to spend some time on myself, on my business. Whatever it is.

Dr. Andy Roark:
There are two pieces of that. One is that we’re relaxing in some rigidity of how we think things are supposed to be. Buying into the integration part, I think, is key. You’re working on your mobile practice and everything.
Cassie, there’s nothing wrong with working your butt off, and then stopping at 3:00 PM and receiving your kids from school. Doing the stuff you want to do with them and hanging out and helping them with homework and having some relaxing time and whatever. And then, picking your laptop back up at nine o’clock at night and banging on.

Dr. Cassi Fleming:
You are describing so much.

Dr. Andy Roark:
Exactly. Banging on another 90 minutes of work before you go to bed. That’s not wrong. If that works, because the kids go to bed at 8:30, I’m going to work from 8:30 to 10:00. Not every night, but three nights. Monday, Wednesday, Friday. This is my plan. Or just tonight. I’ve got stuff I need to do. I’m going to pick this back up. It’s not failing.
I think a lot of us, we set in our minds, “I’m going to work from 8:00 to 5:00.” And then, I’m going to be a mom or a dad from 5:00 to 9:00. And then, I’m going to relax in the bathtub from 9:00 to 10:00. And then, that’s going to be my day. When that doesn’t happen because, “Hey. I need to be a mom from noon today on.” Or, “I need to be a dad from noon today, because it’s a half-day at school for some unknown reason.”
I got dumped on it. Or, “I’m going to clock out and go to this 11:00 AM dance recital on Wednesday that the school is putting on.” I’m going to do it, because it’s what’s expected to me, but I’m not going to beat myself up about it. I think a lot of us, we do the thing it takes to be a good parent and we feel guilty about it the whole time.

Dr. Cassi Fleming:
I feel like we have to justify it.

Dr. Andy Roark:
100%.

Dr. Cassi Fleming:
I went to the thing, but I went back to my laptop. Nobody cares. Nobody cares.

Dr. Andy Roark:
Exactly.

Dr. Cassi Fleming:
Did you get the work done?

Dr. Andy Roark:
Did you get the work done? I run a company. We do business conferences, business development, things like that. We have unlimited vacation and I don’t care when you work. And so, that’s how the business is set up. The way that we run it that way is … I’m very problem-focused. Being like, “Hey, Cassie. I need you to fix this problem.” And that’s it. That’s it.

Dr. Cassi Fleming:
I don’t care how you fix it, when you’re going to fix it, how long it takes you.

Dr. Andy Roark:
I don’t care if you do it at four in the morning as long as you don’t call me. I don’t care if you do it four in the morning as long as you do it. But if that works in your life, I think that’s great. I think there’s a lot of rigidity around our schedules that have been kind of imposed over time.
Again, I know that’s not feasible. You can’t have a vet clinic that’s just open whenever we feel like being there. However, I still think there’s a lot of things in our lives where we can say, “Am I supposed to be unplugged from my work from 3:00 PM to 6:00 PM? Yes or no?” Or am I supposed to be engaged with my kids and making sure that I’m giving them quality time and my attention?
The latter is much more flexible. There’s so many more ways to do this. But if it’s, “I’m supposed to be off work from 3:00 PM to 6:00 PM,” there’s only one way to do that. And it’s wildly, rigidly inflexible. I don’t understand why the goal is to be unavailable from 3:00 to 6:00 PM. What is that?
It’s a made-up construct. We put this on ourselves and we act like we’re failing if we’re not available. I think that’s a dumb idea. No one’s like, “Mom. I really wish you’d been available from 3:00 to 6:00 PM.” No one’s like, “Mom, I wish you’d …”

Dr. Cassi Fleming:
I really appreciate that 7:00 to 8:00. But man, the 3:00 to 6:00 is what I needed.

Dr. Andy Roark:
Exactly. That’s what I mean. But your kid is never going to look you in the eye and go, “You know what really mattered to me? That 4:30 meeting thing you canceled.” What matters is the relationship that we have. It’s funny. I’ve been through periods in my life where I beat myself up because I was working too hard. And then, I cut back and I beat myself up, because I wasn’t working hard enough. You know what I mean?

Dr. Cassi Fleming:
Right. Yes.

Dr. Andy Roark:
At some point, I was like, “This is ridiculous.” I’m beating myself up for being with my family and I’m beating myself up for not being with my family. I’m beating myself up for working. I’m beating myself up for not working. I’m like, “Andy. How is this sustainable?” You know what I mean?

Dr. Cassi Fleming:
I do know what you’re saying. And I hope this talk helps a lot of people out there. Because, yes, that is 100% me. And it’s so comforting to know that I’m not the only one that’s doing that.

Dr. Andy Roark:
No. No. I don’t think you are. We’re all hard-driving people. I think a lot of it is stepping back. For me, that whole thing of we choose how we suffer. I think a lot of it’s stepping back and saying, “What is possible? What is important? What am I trying to accomplish here?” I think most of us never stopped and said, “What am I trying to accomplish?”
Honestly, think about how many veterinarians went to vet school. They learned the thing and they were like, “Hey, professors. What am I supposed to do?” The professor is like, “You should do an internship.” They’re like, “All right. I’m going to do an internship.” And then, they’re like, “Hey, internship. What am I supposed to do?”
They’re like, “You should get a job.” You’re like, “I’m getting a job. Hey, boss. What am I supposed to do?” “You’re supposed to see 20 appointments a day forever.” You’re like, “I’m doing it.” At any point, did you stop and say, “What do I want to get out of this deal?”

Dr. Cassi Fleming:
I think there’s a term, micro-flexibilities, that basically is saying, we have two income households and there’s a lot of things going on and things are really busy. Like you said, to not hold to these very rigid schedules. To say, “I’m going to take an hour here. I’m going to take an hour there and focus on that.” And not beat yourself up for it. Not feel like you have to justify it to yourself or other people. That’s where I really struggled.

Dr. Andy Roark:
Well, I think the biggest thing for me in making that happen was intentionality. I think a lot of us are very comfortable with the idea of intentionality and planning in our job, but we don’t think that intentionality and planning in our personal life is a thing that we do. I’ll give you the simplest of examples. Life-changing thing for me is my Sunday meeting with my wife.
On Sundays, we’re pretty darn religious about it at this point. On Sundays, we look at the calendar for the coming week and say, “What are we doing for meals? What are you doing in the evening? What am I doing? Where do the kids need to be? Let’s all get on the same page.” What I have found is, again, you choose how you suffer. I can make time and have this meeting on Sunday and get my calendar out and sit with my wife in a way that feels kind of weird … Because I’m like, “Check your availability.”

Dr. Cassi Fleming:
It’s so true though. We do the same thing, but we don’t do it religiously on Sunday. I hope my husband doesn’t listen to this, because he’ll be like, “That is a brilliant idea.”

Dr. Andy Roark:
Well, I tell you. You choose how you suffer. You can either do the awkward meeting on Sundays and make time for it. Or you can have fights on Thursday. Because they’re like, “I thought you were going to take her to gymnastics.” You can have these sacrifices that you can’t see. They’re not in your calendar. “Fight with my wife,” is not on my calendar at any point, I promise. I did not schedule that.

Dr. Cassi Fleming:
No. We’ve talked about other things not being sustainable in the long term. I know nobody wants to fight with their spouse on a regular basis.

Dr. Andy Roark:
Exactly. When I say fight, we’re being overly dramatic.

Dr. Cassi Fleming:
Sure.

Dr. Andy Roark:
But it is that … Not necessarily a fight, but you feel your cortisol spike and you feel the stress. You’re like, “I’m not around tonight to do this thing that you are asking me to do.” They’re frustrated, because their plan is not going and it feels like a fight. Even though you’re both rooting for each other and you’re both being understandable.

Dr. Cassi Fleming:
Right. You don’t want to let the other person down.

Dr. Andy Roark:
Exactly right. You don’t want to let the other person down in any way. Everybody understands that emotional feeling.

Dr. Cassi Fleming:
Sure.

Dr. Andy Roark:
But it really comes back town to you pick your battles. One of my favorite sayings is … A lot of things I talk about in the clinic just apply to regular life. But in the clinic, one of my favorite sayings is, “If there’s something that happens in your clinic again and again and again that surprises you, at some point, it’s not a surprise. It’s your business model.”
If you end up with clients standing around at the end of the day and you’re trying to close the door and they’re like, “No. I walked in here. I’m staying here.” If that happens one time, you deal with it. If it happens once a month, you deal with it. If it happens three times a week, it’s your business model. Having people standing in your lobby at the end of the day.
You can either just accept that that’s what your business model is and be okay with it and make sure your staff is okay with it. Or you can make changes to address it. But acting like, “I can’t believe people are standing in the lobby again.” At some point, you go, “Why can you not believe that? It happens all the time.” Same thing is true in our personal lives.
At some point, if I look around on Wednesdays and I’m like, “What do you mean I’m supposed to take her? You’re supposed to take her.” If I’m arguing with my wife every Wednesday about kid transport, at some point, I’m the doofus who hasn’t figured out yet that Wednesday kid transport is a problem, and we need to sort it out intentionally and figure out how we’re going to get this done.

Dr. Cassi Fleming:
I feel like we’ve come full circle here with the intentionality. I feel like a lot of it does come down to intentionality in our self-talk. How we think about ourselves and how we talk to ourselves. How we express that to people.
Because whether or not it should be important, and I think we’ve determined that it is … Just that it can offer a lot of peace when you sit down and have that self-reflection or that Sunday meeting. Or whatever it is. To really know where you stand and you’re not just kind of flailing.

Dr. Andy Roark:
I think that’s really important. It’s validating yourself and it’s validating your spouse. You know what I mean? It’s saying, “Hey. I see you working hard.” It’s funny. If you take a second and think, “What’s really important in your life?” Is it your net promoter score as a veterinarian? Or is it how your spouse feels about you? You might say, “Well, it’s how my spouse feels about me.”
I go, “Well, your spouse probably feels the same way. When’s the last time you told your spouse that they’re crushing it?” When was the last time you told your spouse, “Hey. I just want you to know. There’s no measuring stick for this, but I want you to know that you’re succeeding. You’re winning.” We don’t get a lot of that. And I think that’s a problem.

Dr. Cassi Fleming:
Sure. Sure. Absolutely. I know I can think about that. My husband’s great about having those little kudos moments and stuff.

Dr. Andy Roark:
Good.

Dr. Cassi Fleming:
And it really changes my whole day.

Dr. Andy Roark:
That’s awesome. It’s like in vet medicine a lot. There is no scenario where everything in the clinic runs smoothly. There’s chaos baked into the bread. In vet medicine, there’s too many things out of your control. There’s emergencies. There’s people walking in.
Pets get sick. They can’t control pet owners. You know what I mean? I think we can kid ourselves that, “I’ll get this figured out and there’ll be a system and people will show up on time for their appointments,” and blah, blah.

Dr. Cassi Fleming:
Wait. That doesn’t happen?

Dr. Andy Roark:
It’s never going to happen.

Dr. Cassi Fleming:
That’s a lie I tell myself.

Dr. Andy Roark:
We tell ourselves a lie. It’s never going to happen. It’s never going to happen. We need to just go along with the idea that there is chaos. There’s going to be some chaos, but I can still be intentional. I can still try to set myself up for success. I can still adapt based on what happens, but I don’t know.
I think that chaos can be fun and it can be rewarding. It’s part of what we are. If you feel like you’re failing because there’s chaos, I think that you are failing because vet medicine is vet medicine. That’s just what it is.

Dr. Cassi Fleming:
No. I very much relate to that statement. Control the things that you can control and that allows you to lean into the chaos a little bit and have fun with it. My day got totally derailed this past Tuesday, where I had a full schedule and then I had multiple emergencies walk in. Literally dying. It just was what it was. But because the rest of it was controlled and we knew what to expect, we dealt with it. We did a lot of good.

Dr. Andy Roark:
Well, I have a niche analogy for this. I’ll give it and that’s maybe where we’ll wrap up. I don’t know if other people appreciate this, but I’ll tell you this. If you think about your team at the vet clinic, your vet team, it’s The Muppet Show. It’s The Muppet Show.
When you think about The Muppet Show, there’s two kinds of Muppets. There’s Order Muppets and there’s Chaos Muppets. The Chaos Muppets are the ones who, they’re riding bulls. They’re trying to change the show on the last minute. It’s Gonzo shooting himself out of the cannon without any practice. No targeting. Complete chaos.

Dr. Cassi Fleming:
Sure.

Dr. Andy Roark:
And then, there’s the Order Muppets, which are like Scooter. They have the clipboard. They’re like, “No. This has to go and these people have to go.” The whole Muppet Show is a battle between the Chaos Muppets and the Order Muppets, and they battle for control.
Every single episode of The Muppet Show is Chaos versus Order, and Kermit the Frog is the linchpin. He’s in the middle. His job is to balance the Order Muppets and the Chaos Muppets. He’s always just about overwhelmed. And then, he pulls it out. And so, if The Muppet Show was a basketball game, every single show, the score would be Chaos, 98. Frog, 99. That’s how The Muppet Show works.
That’s your vet clinic. Every day is this chaos and you’ve got the Chaos Muppets, and you’ve got the Order Muppets. You need them both. You can’t just have the Order Muppets. The Chaos Muppets, they exist. They’re real. They may be pet owners that come in from the outside, but they’re going to bring that chaos.

Dr. Cassi Fleming:
Chaos Muppets. This is what I’m going to start calling pet owners.

Dr. Andy Roark:
They are Chaos Muppets. And there’s people like me who are completely Chaos Muppets. I am 100% in that regard. But it’s funny. We do this thing, and I hear it all the time in business. People talk about, “I want my practice to be Disney.” You think about the Disney princesses. Everybody shows up where they’re supposed to, and they’re all put together and they’re beautiful. And this is how it goes. This is the time.
The Prince shows up as they’re supposed to. That is not how this works. It’s not Disney. It’s The Muppet Show. And so, if you own that and go, “It’s The Muppet Show,” it makes everything feel okay. Because the expectation is not, “This is Disney and a well-oiled machine. Everyone is on their spots and they’re all hitting their cues.” It’s like, “Nope. This is chaos.” We’re going to pull it out. Chaos, 98. Frog, 99.

Dr. Cassi Fleming:
I love that. It just makes it so much more fun. I’ve been guilty of feeling like I’m failing when the Chaos Muppets take over. I’m going, “Wait. Why don’t we have systems for this? Why didn’t I foresee this?” It’s good to know that that’s just reality.

Dr. Andy Roark:
Sure.

Dr. Cassi Fleming:
And that’s okay.

Dr. Andy Roark:
Well, you should keep making systems. You should keep making systems. The Order Muppets have to keep working.

Dr. Cassi Fleming:
Because the Chaos Muppets will.

Dr. Andy Roark:
They will. Exactly right. They will manifest as different chaos. The difference in a thriving business and in a thriving life, and a struggling business or a struggling life is … In a thriving business, you tackle a new problem every day. In a struggling business, you have the same problem every day.
And that is the difference in a thriving life and a thriving business and a struggling life and a struggling business. If you are dealing with the same problems again and again, you’re in trouble. If you’re dealing with new problems, you’re living a healthy life. Because there is no scenario where you don’t get problems. And then, this goes back to the quagmire we were talking about before. Is there a light at the end of the tunnel?
The truth is, if you’re solving new problems, there’s a light at the end of the tunnel. If you’re back in the same problem every day, that’s the struggle bus. Because you’re doing the same problem over and over again. Anyway, the answer is not a life without problems. The answer is a life with new problems every day.

Dr. Cassi Fleming:
Do you have four more hours? Because I could sit here and continue to pick your brain for double that, but I promise I would cut it off at four hours.

Dr. Andy Roark:
No. I’ve got a massive conference to explore here.

Dr. Cassi Fleming:
It is massive. Goodness. We’ve been having all kinds of fun with people coming and taking pictures and making faces in the fishbowl.

Dr. Andy Roark:
If at any point, I lost my train of thought, it was because someone was making faces at me through the glass from outside. That’s happened a couple of times.

Dr. Cassi Fleming:
I think we did a pretty good job of maintaining our focus. Despite the Chaos Muppets.

Dr. Andy Roark:
I hope so. I hope so.

Dr. Cassi Fleming:
Well, Andy, this has been great. Thank you so much for coming and sitting down with me in the booth. I hope we get to do it again.

Dr. Andy Roark:
Sure.

Dr. Cassi Fleming:
We don’t even have to turn the microphones on. Every time you talk, it seems to be exactly what I need to hear. I’m not alone in that. I think this will be what a lot of people need to hear.

Dr. Andy Roark:
Well, thanks for saying so. And that’s it, guys. That’s what I got for you. Thanks again to the team at VetFolio Voice for letting me share this with you. Like I said, I hope you’ll check out their podcast. They’re great people doing great work. Man, what a wonderful experience it was to work with them. Anyway, guys. Take care of yourselves. Be well. I’ll talk to you soon.