DrAndyRoark.com

Articles, Videos, & Training on Pets & Veterinary Medicine

Wellness

New Research: What Are Veterinarians Actually Willing and Able to do about Suicide?

by

Doctoral candidate Sydney Waitz-Kudla joins Dr. Andy Roark to discuss her recent peer-reviewed publication on securing lethal means for suicide in veterinary practice.

WARNING: This episode discusses suicide and the means for suicide. Listener discretion advised.

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

LINKS

Article: Securing lethal means for suicide: a focus group study exploring perceptions and barriers among practicing veterinarians

Lifeboat by NOMV

Sydney Waitz-Kudla on LinkedIn

Uncharted Veterinary Conference 2023

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

Sydney Waitz-Kudla, M.S., received her BA in psychology from Vanderbilt University in 2015. She spent two years at the Vanderbilt Kennedy Center and two years at the University of Southern Mississippi as a Project Manager before coming to Auburn in 2019. Sydney is a fifth-year student in the AU Clinical Psychology Program and Presidential Graduate Research Fellow. Her current research is focused on means safety intervention and suicide prevention for veterinarians. 

Sydney loves to travel and has lived in 8 states across the US. She has two dogs named Kiwi and Mango and has been riding horses for over 20 years.

EPISODE TRANSCRIPT

Dr. Andy Roark: Welcome, everybody, to the Cone of Shame veterinary podcast. Guys, I am your host, Dr. Andy Roark. Guys, I’ve got a good episode today with my friend, Sydney Waitz- Kudla. She is here presenting her newest research. Which is on what veterinarians are actually willing and able to do about suicide. This is a suicide episode, just go ahead and give a quick warning if that’s upsetting to you. Or, and we don’t get too deep into it. It’s not a graphic episode, but we do talk, pretty, pretty candidly about suicide in the vet profession. And so, if that’s upsetting, this is probably a good episode to skip. I think this research is really important.

It’s great to think about what’s possible. I love to have conversations about how we can fix problems. I think it’s also really important to be pragmatic of what are people able to do? What are they willing to do in their practices? Because those are the changes we could actually start to make. And so Sydney has done some outstanding research and I link to it in the show notes and everything.

We get all up into it. But, but that’s, that’s what we’re talking about. So guys let’s, I’ll let her take it from here. 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. Sydney Waitz-Kudla. How are you?

Sydney Waitz-Kudla: I’m good. How are you doing, Andy?

Dr. Andy Roark: I am really good. It is so good to see you. You and I have known each other for, it must be almost five years now. It’s been a few years. We’ve known each other. I I met you through, Dr. Tracy Whitty and her research that she was doing on suicide prevention and things like that. And you are, for those who don’t know you, you are a fifth year doctoral candidate at the clinical psychology department at Auburn University.

Correct?

Sydney Waitz-Kudla: Yes, under, and Tracy is my mentor.

Dr. Andy Roark: Very nice. And you specialize in suicide prevention research. And you have a new article that came out in JAVMA. I got to be a co-author on the article, although I did very little for that accolade. But hey, I’ll take it. I’ll take it.

But it was lovely to be included. I love the research that you’re doing. I think suicide prevention and veterinary medicine obviously is extremely important. Mental health and wellness is something I’m really passionate about. I really liked the, the article that you put out.

It was titled “Securing Lethal Means for Suicide”, and it was a sort of a survey article on veterinarians, and it was all about lethal means for suicide. And so let me just go ahead and pause here. And can you give me kind of an overview of the research and kind of what you set out to try to look into?

Sydney Waitz-Kudla: Yeah, and I will say too, I feel like, honestly, the consultation that we were able to get from you, just discussing all of the different ins and outs. We like Tracy and I both have been doing research in this area, but we’re not veterinarians. We don’t know what it’s like to be a veterinarian.

And so having those contacts within the veterinary community is so important. I also think that you were a vital part of us being able to get all of our participants. So thank you for all of the things that you did. 

Dr. Andy Roark: I love to support where I can. So that was, but you’re doing great stuff.

Sydney Waitz-Kudla: Thank you. And so, basically what we were doing is we know, from Dr. Witte’s 2019 study, something that she found was essentially that pentobarbital is one of the primary methods utilized by veterinarians for suicide. And so, that was actually the year that I came into the program and we said, okay, this is a problem.

And I came in saying, I want to start working towards finding a solution to this problem and saving veterinarians’ lives, how can we prevent suicide so that then we can help improve the mental health of the veterinary community. And so what we did is we kind of had to start from the ground up because there is so little research on veterinarians and suicide.

And so, what we were doing is we did a focus group study. Basically taking veterinarians from a variety of different specialties and talking to them about, “Hey, we know that pentobarbital is a primary method utilized by veterinarians. What do you see as the reason why?”, and what we saw across the board and something that, at least when I’ve discussed it with, other veterinarians hasn’t been surprising is that it’s easy access to that drug. And so, we’re approaching these focus groups with the mentality of, okay, we know that this is a problem. And so, what would veterinarians be willing and able to implement in their workplace to potentially save the lives of themselves or of coworkers?

And so that was kind of the main goal. Was investigating what to them feels like it’s not going to stop them from doing their job, but would create barriers such that. If they were suicidal or if someone else in the practice was suicidal, they wouldn’t be able to access that drug or suicide, which falls into mean safety research and is a big push in the like suicide research community right now.

Dr. Andy Roark: I love that you do this because I remember beating the drum. We talked about Four Eyes Save Lives and I was, I’ve been a big advocate for means for means safety and means control. And I really do think that we can do a lot for suicide rates for veterinarians through control of substances that , that are used for suicide.

 And then Tracy Witte put out this great paper that really supported that premise. And so, obviously I like that a lot because I was very much sold on that. And I was like, I really, this is what I see. And this is. This is, this all makes sense to me and all fits together.

And so I really liked that a lot. And so I remember her article came out, and the research came out and I was shouting it from the rooftops and I was like, this is guys, we need to pay attention to this. And there were a lot of people who listened. But I have to tell you, honestly, Sydney, I was surprised at the amount of pushback that came back from that saying, but I can’t do that in my practice.

And, this doesn’t work for us or we need to be able to move too fast. And again, I’m not saying that those people were incorrect in their assessment. It was just. It was not one size fits all. And there were a lot of individual concerns and a lot of people had very strong beliefs about what was possible to do and what was just not going to work in their practice.

There were a lot of people who were like, I’m a solo practitioner. I’m the only one who’s here. Or I do, I’m a large animal practitioner and it’s me and my truck by myself. And I have these limitations on access to lethal medications. And it was funny because I was surprised to get such pushback and it still made sense.

And so I, what I really like about the research you’re doing is starting to dive into that and saying, okay, moving past the idea that this is important. What would actually work and what are the barriers to having something that actually works there? So so yeah start to unpack for me what you found. What were your takeaways?

As far as the roadblocks and the things that people were willing to do

Sydney Waitz-Kudla: Yeah. And so I think that is actually a really important. point that you make talking about, it, you were one of the people that kind of came up and said, Hey, this is a possible solution. The Four Eyes method, having two people necessary to open pent up arbitral storage. And something we were talking about, even when we were creating this study was okay.

Andy received all of this pushback. So we need to investigate why. And also is there a solution that could work for folks? That the Four Eyes method wouldn’t work. And so, that was a lot of that conversation. And something that I know we also talked about as we were finalizing that publication is okay.

What about the Four Eyes method? What about having two people and something that we talked about and something that came up in those focus groups was essentially that. Even though that is such a good idea in theory, it was almost that of all the solutions that we discussed, that was one of the ones that for as many benefits that people talked about and for as many times as people said, I could do this, just as many people said I could not do this for the reasons that you mentioned, there are solo practitioners. There may have be times that they are the only person at their practice. They might not have even. A practice manager that is working at the front.

It’s just them or large animal practitioners that they sometimes are going in the middle of the night to. An animal and it’s just them and the truck and the animal. And so, to say, “Okay, on the one hand, could it be that, there is a solution that would work kind of across specialties, or is it that we need to have different solutions for different specialties?”

And it was something that, we really approached it saying it could be either of these. And I think I approached these focus groups saying it could be either way. What that allowed us to do is that when I talk to veterinarians and we used an iterative process that as I went through the different focus groups, sometimes we would talk about.

Here’s something that some people have mentioned. Does that seem feasible to you? And talking about, you know, what might work for different populations. We had a variety of focus groups, some of which were small animal vets, some of which were mixed animal vets and large animal vets and equine vets. And those were kind of our three big populations were a small animal, mixed animal, and then large animal and equine since they usually have similar barriers.

We did put those equine and large animal together, and then we had a variety of focus groups that had people from multiple different specialties as well as academia or government lab, animal, medicine, and those sorts of specialties. And so what we found is that across. Specialties, folks were really willing to implement adding an extra lockbox specifically for pentobarbital. So what this would be is that either within the storage for other medications or separate from that storage, there would be a lockbox that remains locked at all times, except when euthanasia is being conducted with the idea being that. What a lot of folks talked about is that okay, I need to go in and out of drug storage all day I can’t have that cabinet locked all the time because I’m so busy.

I have so many patients coming in I can’t be having to go back and forth and back and forth all day. And so talking about okay If we had pentobarbital specifically locked something that you don’t need to access all day, every day, and that was only unlocked when you needed it for your job. Is that something that you’d be willing to implement? And across the board we saw that folks “yes” and at least more so than anything else. And we also saw at post test that, by and large, most people said that would be something that they’d be willing to implement. And we had some folks that said, it was lockbox, an extra lockbox for pentobarbital, and then nothing.

And for the nothing, it was folks that already had really secure storage, already had something like this in place, and they said, okay, I wouldn’t add anything additional because I already have something similar to this.

Dr. Andy Roark: Yeah

Sydney Waitz-Kudla: That was really cool to see, just that this was something that worked across specialties.

And I think that kind of the two main barriers that came up for that method, that would be something that we would really need to take into account on a practice by practice basis is that for some folks, they said either, I just don’t have a lot of space, which especially came up for large animal vets because they are working out of a truck. It might be hard for them to find a separate place in that truck or a place within the cabinet they already have to put that extra lockbox, but is something that they were really willing to do. When we discussed, okay, mean safety does have a basis in research. We do know that this is something that is effective for preventing suicide.

Then we started to see veterinarians saying, okay, If this is something that you can say “it, it will likely work. It’s really something that could be helpful for preventing suicide. I am willing to give it a shot. I’m willing to figure out how to do it.” The other thing that came up, but I think is also something that would just need to be taken into account as far as when might it be important to keep this in mind, when might this be something that comes up is situations in which an animal might be in an emergency situation and that extra two, three, four, five minutes that it takes to unlock the extra lock box, it’s this cost benefit analysis of, is it worth that extra five minutes of suffering for that animal? And something that I think came up in our conversation in the manuscript is that’s something that, would there be more utilization of sedation in those situations using a drug that would be in that regular cabinet to make sure that dog or that animal, whatever animal it is, isn’t suffering.

And then having that extra few minutes that the animal is in a better state to access that pentobarbital and then conduct euthanasia. So those were the conversations that kind of happened, but something that was, even though we had all these conversations about barriers, which I think is really healthy because we need to discuss what barriers might come up before we can implement something.

At the same time, it was really good to see that after the fact, when we asked them at post test, what would you implement? That was something that came up time and time again, as I would add an extra lockbox or, even adding a time sensitive lock that it would take, they basically put in a code or something like that, and then it would take a few minutes before they could unlock the pentobarbital storage.

Dr. Andy Roark: Oh interesting. I like that a lot. 

Hey guys, my favorite time of the year is coming up. It is the April Uncharted Conference. Guys, April 18th through 20th in my hometown, Greenville, South Carolina. The Uncharted team and I we’re putting on the show. This is the conference that I started with the gang in 2017. If you’ve never been to an uncharted conference, it is not like anything else you have been to it is all about Active learning.

It is all about collaboration, working together. When I set out to build the Uncharted conference, I built it to be the conference that never ends. I built it to be jam packed full of new ideas and fun ideas. I built it to take those conversations that you have in the hallway, which are actually the most valuable part of a veterinary conference, and put them center stage.

This is all about connecting. Getting to know people who were running businesses, who were leading teams, who were making things happen. I want you to leave inspired. I want you to feel like everything is possible. I want you to have tons of new tools in your tool belt. I want you to have tons of new friends and new connections who are enjoying vet medicine, who like it, who are like, this is a great profession, and I’m excited to explore more.

Do new things, make waves, and have an impact on my community, on my clients, on the patients that I see. Those are the people who come to Uncharted, and so if that sounds like you, and you’re like, God, I need those people in my life, come on to the April Conference. This April is called Chaos Island. It’s Standing Out in a Sea of Noise.

This is all about refining your brand voice, your practice voice for effective communication. That’s with clients. It’s also going to be with teams. I always like to weave strategy and running teams effectively into what we do. A lot of you are seeing a drop in your client numbers. A lot of you are starting to see open appointment blocks that you did not see in the past.

Guys, we anticipate this. We saw it coming in our uncharted community, and we are going hard in the paint to get your appointments full up again, keep you busy. Make sure that your clients know the importance of what you do and they get their pets in to see you and they’re happy to see you. We’re always talking about making sure that you have the right clients for your practice and how to get those people, how to make, how to make your life better. How do we enjoy practice more? How to make your team enjoy practice more. A lot of that comes down to the messaging that we send, how we communicate, how we train, how we set up for success. The battles that we choose to fight and the battles that we don’t choose to fight. All of those things are going to be things that we are focusing on.

So if you’re like, man, I want to hang out with that type of person. I need a dose of positivity. I want to fall back in love with vet medicine. Also, I like talking to clients. I like working the exam room and being effective. I like marketing. I like thinking about who we are as a practice and what makes our practice special.

This is the conference for you. Also, this is going to be the last one we have in Greenville, South Carolina for a while. And a lot of you guys have been coming to Uncharted conferences for a long time. A lot of you love it. Some of you met the people that you married at these conferences.

Some of you have met the best friends you have in the world in these conferences. We’re going to go away from Greenville for a while and it’s going to feel different and it’s going to be fresh and fun, but also I think it’s going to be a little bit poignant. when we leave the nest, and so I do expect this event to sell out, and early bird pricing is going away, early bird pricing, it wraps up on January the 17th if you’re coming and you know you’re coming, and grab a spot before the 17th, because that’s when early bird pricing ends.

So I’ll put a link in the show note to get y’all set up and registered. If you’ve never been to Uncharted before, man, this is going to be a great one. I’d love to see you there. I’d love to shake your hand and welcome you to the tribe. So anyway, guys, let’s get back into this episode. 

Was there anything that you were really surprised by? So you’re getting this feedback, you’re doing these focus groups, you’re having conversations. Was there anything that just you were not expecting going in?

Sydney Waitz-Kudla: So I think that. A lot of it really made sense as far as what we were expecting when we were going in. I think that the one thing that I didn’t expect just as far as it was a, a good surprise was that I didn’t expect that the research backing up mean safety would have such an impact on veterinarians willingness to implement extra protocols. I think that I come from working with populations that aren’t scientists. And so it was something that as soon as it started to happen, we knew it made a lot of sense. Veterinarians are medical professionals, they listen to research, they’re really receptive to research. And so bringing up a lot of this research that is really important and has shown that mean safety can be really effective and really can prevent suicide.

Just seeing that quick shift that information caused in veterinarians’ opinions and tone was something that was really nice to see and something that I think really made us see, okay, this is how we can get that buy-in, get that willingness to do something that could make a really big impact.

Dr. Andy Roark: Yeah I liked that a lot. One of the things I was surprised about starting to have conversations and when we started talking about Four Eyes and things like that I was amazed at how many people, I guess that lived experience carries a lot of weight with people.

And I was surprised at how many people were like, “Andy, that’s never been a problem, you know, or just, I’m, I am not concerned about my own safety. This is not anything that I can imagine myself ever wrestling with,” and I think that’s probably genuinely true for those people. I think the benefit of the research was to be able to say, I understand you feel this way.

Here’s data driven proof that other people don’t necessarily don’t feel that way. And you know, I really believe that veterinarians are generally as we’re stereotyping a large group here, but I do think it’s true. I think veterinarians are very compassionate people. And so I think that the research sort of illustrating the fact that other people have this concern and or have this problem.

I think if you can show that to veterinarians, it definitely seemed to make an impact in the way they think. So I think that’s probably the most useful part of the research as a part of this really meant a lot to me. Sydney, where do you think suicide research in veterinary medicine goes from here?

Sydney Waitz-Kudla: So that is actually where we get into what we’re doing next. You know, just kind of brief overview is really investigating, okay, how can we present this in a way that might be you know, might help veterinarians say, okay. Yeah, this is something that is a good idea. And really figuring out. Okay. I know when I have a long focus group discussion with veterinarians we do get that willingness and so now it’s okay, how can we get this willingness? How can we portray what we want to do? What means safety is in a way that veterinarians have that buy in. You know the future kind of looks into what can we implement? You know, I know we talked about that. We know that a lot of veterinarians are willing to add an extra lock box for pentobarbital storage.

And so now it’s saying, okay, how can we discuss this as a protocol that could be implemented and then hopefully further down the line is seeing if we talk about it, is it something that veterinarians do implement in their workplace? Are there additional guidelines that would be necessary to put into place just as far as legal things to be able to add those extra protocols in the workplace, on a national scale?

What would we need to do, figuring out what is the red tape what, allows us to really disseminate this information. And then also do we see that once we tell veterinarians across the board, you know, okay, this is something that could be really helpful if we are able to get that buy in, do we then see that they actually implement it in their workplace?

If so, great. If we start to see that this becomes more of a cultural change. That’s awesome. And if we don’t see that kind of implementation on the back end of talking about this as an additional protocol to implement, what do we need to do additional to help get that actual implementation piece? And I will say, too, that something that you mentioned just a little bit ago, as far as veterinarians saying, “I, I’ve never experienced this. I don’t think I ever would experience this” is that was a smaller, but also, I think, pretty significant part of our findings from this study was that. When we asked veterinarians, their reasons for which they would be willing to add an additional lockbox or add additional protocols for pentobarbital storage from pre test to post test, we really saw a relatively low number of folks who said, I’d be willing to do this for myself. Like, my own safety would be a reason I’d be willing to do this. It was pretty low at pre test after we talked about it in the focus groups, pretty low post test. But, when we asked about for the sake of your co worker’s suicide risk, would you be willing to implement an additional lockbox or other protocol for pentobarbital storage, we saw that at pretest, they had some willingness to say, okay, if it was for someone else’s, suicide risk I’d be willing to do it.

And then at post test, we saw a significant increase in the number of folks who said, I’d be willing to implement this for the sake of my coworkers. And so that’s something too, that we have in our mind as we’re discussing next steps as far as how do we, you know, not only talk about how veterinarians can keep themselves safe, but also others.

And I’ll be interested to see, as we go down that line, how we can get that extra buy-in from folks that do work by themselves. Or, do work by themselves out of a truck are solo practitioners and, how can we also get that buy-in from them without having a one and a half hour conversation about mean safety?

Dr. Andy Roark: That absolutely tracks with the experiences that I’ve had talking to veterinarians about this over the years like that, that totally it’s, it’s just nice to see that bared out because just anecdotally that was, I felt like I was having that conversation again and again, it was always just interesting to me how little traction there was around, “Hey, this is for your benefit”. ” like, Eh, I’m like, I’m good”. But, there was much more interest in keeping other people safe. And I just, I don’t know, I think that maybe speaks, it speaks a little bit maybe to the personality of veterinarians. I think that’s interesting. I do think that there’s some weird ties to our culture and sort of our, our self identity as veterinarians there. So anyway, I think that’s really interesting. Sydney are there any resources that you are really big on right now that you wish that more people knew about?

Sydney Waitz-Kudla: Yeah, so one of the initiatives that I’ve been a part of since it started was Lifeboat by NOMV, Not One More Vet. And so that is a peer support anonymous resource for veterinarians. It is essentially veterinarians providing support for other veterinarians. And it’s something that you can sign up for. If you go to lifeboat.NOMV.org, I believe, and then.

Dr. Andy Roark: I’ll put a link to it in the notes. Yeah.

Sydney Waitz-Kudla: Awesome. And so that is something that if you are struggling as a veterinarian with mental health, and you really want to talk to folks that understand that’s a really great resource for those veterinarians. And additionally, if there are veterinarians out there who say, “Wait, I want to be supporting my peers, my colleagues, then they can also sign up to be companions and be the supports for other veterinarians.

Dr. Andy Roark: No, I love it. I’ve had some I’ve had some guests on recently. Lifeboat has come up a couple of different times. I said, I’ll put a link to it in the show notes so people can learn more. It’s a wonderful program. I am super happy that I love that you’re involved with it. I’m super happy that the NOMV group is putting it on.

It’s just I don’t know. It’s, it makes my heart happy to know that it’s out there and people are doing that work. Sydney, thank you so much for being here. I really appreciate your time. Where can people find you if they’re really interested in your research and they want to see when you’re publishing in the future where, where can people connect with you?

Sydney Waitz-Kudla: So as of right now, the best place to find me is on LinkedIn. And so if you search my name, you can find me. And then additionally, the paper that we just published is coming out in JAVMA in the ‘Journal of the American Veterinary Medical Association’. And so, keeping an eye on that paper or that publication and then additionally keeping track of me on Google Scholar or anything like that is where you can see a lot of my publications.

Dr. Andy Roark: I will set up links to all that stuff as best again, down in the show notes so people can find it and and keep up with you. So anyway, thank you so much for being here, guys. Thanks for tuning in and listening. Take care of yourselves, everybody.

And that’s what we got. Guys, I hope you enjoyed it. I hope you got something out of it. Thanks to Sydney for being here. Thanks for you guys for listening. Like I said, it’s a heavy topic. It’s an important topic. It really is. I want to keep our colleagues safe. Um, I want this to be a profession where people flourish.

And we need to look out for each other. And so anyway, that’s why we keep coming back here and just seeing what we can do. I love this episode because it’s actually talking about what can we do? What’s on the table? What are things that are actionable? How do we feel about this as a professional?

What are we, what steps are we willing to actually take? And so anyway, I think these conversations are really worth having. So thanks for being here and participating. Guys, take care of yourselves. I’ll talk to you later. Bye.

Understanding the Role of Nutrition and the Microbiome in Overall Pet Health

by

Dr. Caroline Mansfield, registered specialist in internal medicine and honorary research professorial fellow at the University of Queensland and clinician at James Cook University, joins Dr. Andy Roark to discuss the role of the gut microbiome in the health and disease of dogs and cats. Caroline provides an overview of the importance of the microbiome in general pet health, the impact of antimicrobials, and her thoughts on what future research in this area might find.

This episode is made possible by Purina Institute!

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

LINKS

Purina Institute CentreSquare

Get the new Purina Institute Clinical Nutrition Handbook for free!

The Purina Institute

Microbiome Forum

WSAVA Nutrition Toolkit

JCU Vet

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

Professor Caroline Mansfield is a registered specialist in small animal medicine and is recognised as an international leader in veterinary internal medicine, as evidenced by frequent invitations to present at international conferences, requests to provide expert opinions and current and previous roles in the profession. She is a past Board member and President of the Australian and New Zealand College of Veterinary Scientists and has been a member of the Board of Examiners for the National Veterinary Examination. Her expertise is recognized outside of the sphere of clinical veterinary medicine by participating in the peer review process for Australian Research Council Discovery Early Career Researcher awards (DECRA) and Discovery projects from 2015 to present. She is currently Chief Editor for the Australian Veterinary Practitioner, on the Editorial Board for Animals, a member of the Purina Institute advisory group and received the 2019 Award for Scientific Excellence from the Australian Small Animal Veterinarians. She is currently an honorary research professorial fellow at the University of Queensland and clinician at James Cook University, located in tropical far north Queensland. Her research is focused on the interaction of the gut microbiome in the health and disease of dogs and cats, and the role diet and environment play in this. She also researches in areas of clinical gastroenterology that can result in tangible improvement in the health and welfare of our pets. She has published over 90 peer-reviewed papers plus multiple textbook chapters and conference presentations. To date, she has supervised over 30 post-graduate students and clinical residents to successful completion.

EPISODE TRANSCRIPT

Dr. Andy Roark (00:07):
Hello and welcome everybody to the Cone of Shame Veterinary Podcast. I am your host, Dr. Andy Roark. Guys, I got a great one today. I am here with Dr. Caroline Mansfield. She does a lot of things that I will talk to you about when she comes onto the podcast, but her main emphasis is in research on the interaction of the gut microbiome in health and disease in dogs and cats. And so I think she’s fascinating. I think gut microbiome research is fascinating. I am really amazed and odd as you will hear about what we are learning about gut health and how gut health interacts with health in the rest of the bodies and how basically every organ system can be tied back in some way, shape or form, probably to the microbiome and into gut health. And so anyway, we start talking about cognitive dysfunction and the role that the microbiome plays in that we start talking about where prevention and treatment of a variety of the illnesses might go in the future and what research in gut microbiome looks like in that.

(01:08):
If you just don’t know much about sort of the gut microbiome research and why people are talking about it and why it’s becoming a big deal in nutrition in general animal health, this is a great episode. I talked to her a little bit about the wellness industry and about the noise that’s generally around nutrition and things like this and how to kind of separate out what is worth talking about and what is not, and try to get our head straight so that we can be a valuable resource when we talk to pet owners. So anyway, it is a sprawling conversation about a topic that I think is incredible, and so you’ll hear my wonder and excitement when you get into this episode. I hope you’ll like it a lot. I have been thinking a lot about this episode since we did it. Anyway, that’s enough. Let’s get into this episode with Dr. Caroline Mansfield. Also, I got to say thanks to Purina Institute, they are making this episode possible ad free for you guys, and so shout out to them. Let’s get into it.

Kelsey Beth Carpenter (02:01):
(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 (02:17):
Welcome to the podcast, Dr. Caroline Mansfield. Thank you for being here.

Dr. Caroline Mansfield (02:22):
Oh, thank you. You’re welcome.

Dr. Andy Roark (02:23):
Oh, it is a pleasure to have you here. You had to get up really early for this podcast. I really appreciate it. You are. For those who don’t know, a registered specialist in internal medicine, you are a past board member and president of the Australian and New Zealand College of Veterinary Specialists. You are the chief editor for the Australian Veterinary Practitioner. I could just keep going and going have, but you have over 90 peer reviewed publications. My wife is a college professor. I don’t know if people know how amazing that is, that incredible amount of work. You have supervised over 30 graduate students. You have done absolutely incredible things. And so I really just, I appreciate making time to be here. I want to talk with you about nutrition and there was something I was really sort laxing philosophical about as I was sort of preparing for our time together and I was thinking about having you come on and stuff like that.

(03:20):
And so I’ve got this idea that we do not look at life and especially at medicine with the wonder that it deserves. And so I look around at our world and just simple concepts like our physiology, our immune system. It is absolutely astonishing that we have this system that works as well as it does. And I just think about so much of what we do in medicine and we just take it as, oh yeah, well, we have this and we know that and we know that the body works this way in that way, but I really don’t think that we just look at life with the wonder that it deserves. And so your research really focuses on the interaction of the gut microbiome in health and disease in dogs and cats. And so I’m thinking about this idea that the gut microbiome has this role that is so large and sort of ubiquitous through our body and through health in dogs and cats, but also in humans. And I don’t know that people really process what that means. And so let me just sort of open up here at just a high level paint for me sort a picture of how you look at the gut microbiome and its role in healthcare in general, if you don’t mind.

Dr. Caroline Mansfield (04:38):
Sure. I guess it’s kind of interesting that you talk about that wonder and that excitement about medicine and physiology. I feel super excited every time I learn something new about the microbiome or the way that it interacts with the body. I think it’s incredibly fascinating area. It’s probably like having a whole other organism within an organism. So it has an interaction with virtually every organ system is affected by the gut. And the gut is from an immune perspective, is probably one of the most important interfaces with the environment. The gut is usually where we are exposed to multiple antigens on a daily basis. So the gut microbiome influences that immunity, that immune system. It influences the way the brain develops as a child or as a puppy or a kitten influences behavior. It influences kidney disease, influences development of uroliths. It’s fascinating all of the interactions that it potentially has.

(05:54):
And probably what’s even more fascinating is that we didn’t understand how much was there because we didn’t have the technology to identify all of the organisms that were in the gut microbiome until recently. And even now, I still think we’re a little bit limited in how we understand or basic in how we understand because I think each bacteria has the capacity to have different functions. And so there’s this kind of redundancy or fail safe system. So it’s not enough just to know what bacteria are there, it’s what they’re doing, whether they have their buddies there to help them or not. It’s justs just super fascinating.

Dr. Andy Roark (06:35):
I completely agree, and I appreciate you saying that this is fairly new in coming to light because it does feel fairly new. We didn’t have this sort of insight when I was in veterinary school. And so I’m seeing this sort of research coming out and I, I’m trying to get my sort of hands around it and I’m thinking about it in a lot of different ways. So first it’s just my basic understanding of the physiology and how this affects my patients. But then also we start to get into therapeutics. We start talking about wellness care, and then we also start talking about addressing disease states. If you’re talking to, I don’t know, just say a doctor who didn’t have a robust understanding of this coming out of vet school and has been sort of trying to catch up, how do you help veterinarians, veterinary technicians, nurses, how do you help them think about this microbiome just at a systemic level if they say to you, this is all really new to me and I’m trying to get my head around it so I can start to understand and start to talk in a way that’s helpful for my patients.

(07:29):
Where do you start?

Dr. Caroline Mansfield (07:31):
I guess, I don’t know. Well, it’s a little bit lyrical. I sort of talk about the fact that the microbiome, it’s not equally divided. It’s not good or bad, but to have a really healthy community, just like a healthy human community, you need diversity and you need the bacteria or the participants in that community are doing different functions and they’re all contributing together to work towards a particular goal. So I guess the things that we need to be thinking about is that when we talking about nutrition, we can talk about basic nutritional requirements like protein and carbohydrates and fat and so on, but we also need to be aware that any diet that we feed affects that community. And so if we want to enhance a particular function, I’m really loathed to talk too much about particular bacterial species because I think I was alluding to before, particular bacterial strains or species will only be effective if other bacterial strains are present.

(08:40):
And they do have a redundancy in their roles. And so I think it’s better to think about the functionality. And so most diets provide some kind of prebiotics, which it’s kind of like a fertilizer, I guess, to promote growth and diversity of that microbiome. And we also have the capacity to influence it positively by using prebiotics or what post-biotics, which are probably the new emerging fields. So those are the metabolites that bacteria produce, but we also have the capacity to do it a lot of harm. So I think particularly with the use of antimicrobials indiscriminately, we often think, well, we’re treating that urinary tract infection or we’re treating that ear infection or pyoderma, but we’re not doing absolutely no harm to the animal and the animal’s microbiome when we use those antimicrobials,

Dr. Andy Roark (09:45):
When we disrupt that way, when we use systemic antibiotics for cystitis or for, that’s the classic one, is we better safe than sorry. And so we use antibiotics when we have cystitis or even a pyoderma that we could maybe treat topically and we don’t. Talk to me a little bit about the recovery period. How does that manifest clinically? What does the fallout that we see?

Dr. Caroline Mansfield (10:10):
So I think that’s a really good question, and I wish there was a really simple answer, but there’s probably not because each individual microbiome is going to respond really quite differently. And even within an individual there, microbiome might respond differently at different times. I use the analogy of an elastic band. And so if you’ve got a really healthy, fresh, new elastic band and you stretch it, so you give it se antimicrobial, so you disrupt it, you give it for a short period of time and then you release it, the elastic band’s going to go back to normal pretty quickly. But the more that you stretch it, or if it’s an old elastic band or it’s a little bit sick when you stretch it, it just doesn’t go back as normal the next time. So it is highly individualized, and I think we probably don’t, A lot of the analysis that’s been done, a lot of the studies that have been done, the way that the microbiome has assessed probably doesn’t completely answer that question because it doesn’t completely answer the functional capacity. But we know that, for example, metronidazole has impacts for a very long time. We’re talking weeks to months after it’s been discontinued, but again, it’s really highly individual. Some animals will revert back to normal more quickly and some will take longer.

Dr. Andy Roark (11:30):
I think about sort of looking at diets this way and sort of processing what the microbiome means to overall animal health. And we’ve already got people, we’ve had pet owners for decades now who have been very attuned to what their pets are eating. They are very interested in the nutrition and what they feed their pets. It’s something that pet owners can see. They have a feeling of control about what they feed. I can also see this being an area for a lot of confusion. I can see a lot of people trying to do what’s best for their pets and kind of heading off in a sort of misguided directions. Let’s start to take this focus on the microbiome into a more sort of practical clinical conversation. How do we start to advise pet owners on diet selection and what’s important and what are sort of the pitfalls that we might fall in or areas where we might see pet owners kind of going off in a way that’s not productive?

Dr. Caroline Mansfield (12:26):
Yeah, I guess part of the problem with, part of the problem with the microbiome or it’s I guess the downside for its increasing popularity is that there’s a lot of increasing noise around about it and a lot of noise about how to manipulate it. And that kind of corresponds with, I guess that sort of whole wellness industry that I think is being translated into the veterinary pet owners. They take themselves very seriously. I think we have, the advantage with pet food though is that we can control what they eat to a certain degree. And I think as long as it’s a well-balanced diet, I mean it’s been proven and the dog is healthy or the cat is healthy, there’s probably not a lot of benefit in manipulating the microbiome in those animals. So the times, I guess when we start to think about it are once they’ve actually developed disease and particularly gut disease, that’s probably more when we know that manipulating the microbiome is likely to be effective. And also there’s some emerging things that are happening like with cognitive dysfunction in dogs and epilepsy and manipulating the microbiome in those may be beneficial. And I guess also when we think about it with some conditions like hepatic encephalopathy or liver failure, we’ve been manipulating the microbiome for half a century with lactulose, but we didn’t really aware that’s why we were doing it. So I don’t know that I’ve actually answered your question very well though.

Dr. Andy Roark (14:09):
No, no, I think you did. I knew exactly where I was going is the wellness industry is definitely spilling over into pet health, and this is when we start talking about gut microbiome. I hear this in the wellness industry all the time of people talking about protecting yourself against Alzheimer’s, people getting joint health from the supplements that we take and things like that. And there are supplements that are hugely valuable and wonderful, and there’s a lot that’s not. But I think you put your finger right on it. When I said I anticipate the noise of this, I hear a lot, and I don’t mean to start a controversy about this, but there’s a lot of people who put forward raw foods or things like that specifically because they say, oh, the microbiome is important and this is a more robust way to increase diversity in the microbiome and things like that.

(14:57):
And again, I’m not trying to start the raw food, not raw food debate at all, but there are a lot of people who have strong opinions. And so I think I just want to be, I appreciate you answering in sort of an even-handed way. Really what I was looking for is I want to have productive conversations about this and not just jump to conclusions or overstate what is available and what patterns need to look for in their food. So I think you asked it well, are there, the second part of my question was really how does this go off the rails? Are there areas of misunderstanding that you see where either doctors or pet owners, I don’t know, they take part truths or they have common misunderstandings or things that kind of derail these conversations?

Dr. Caroline Mansfield (15:50):
I think personally and probably in my experience not so much. I mean, I think I’m privileged that I work in a referral population. So normally the people are coming to me for advice, and so usually are quite happy to take advice. It’s interesting that there are some people that are very resistant to some diet regimes, but when you start talking about manipulating the microbiome and that there are other ways to do that, so we can use prebiotics, we can use fiber, we can use, probably not so much postbiotics anymore at this stage. They’re not really developed, but we can use probiotics to a certain extent. I find that people are really quite willing to take that on board. They’re probably not, if they’re very set in their ideas about what they want to feed their animal. And I do come across those people. They have really strong beliefs. I tend not to try and work against them. I tend to try and work with them and just to make sure that the diet is appropriate for the animal if it’s not what else they need to have to make that appropriate or if we can help in any way. But I tend to find if I’ll alienate them if I tell them that I disagree with ’em or I think that their diet choice is wrong and then you lose them.

Dr. Andy Roark (17:21):
Right, yeah.I think we’ve all kind had to do that math at some point and to say, is this the hill I want to die on, or do I want to continue on so that that’s right. We can work on the future. Yeah,

Dr. Caroline Mansfield (17:32):
Pick your battles.

Dr. Andy Roark (17:34):
Yeah, definitely. Talk to me a little bit about where you see this field going. I got to tell you, going back to the statement of wonder I had at the beginning, when we start talking about the microbiome and its impacts on cognitive dysfunction, that’s magical to me. That is so beyond what we ever used to think. And the idea that there’s something we can do for cognitive decline or things like that is amazing. Where do you see this sort of research going? How do you see the science here manifesting out into healthcare into actually treating dogs and cats in the future? What’s this going to look like?

Dr. Caroline Mansfield (18:17):
So what I’d love it to look like, so there’s a few things in the human field. So there’s something that was called the American Gut Project. It’s a bit of a misnomer because they do get samples from around the world, but where they’re basically screening people and looking for, I guess if there’s geographical differences, seasonal differences and so on. And we don’t really know that that well in dogs yet, partly because of the costs of sequencing. So a lot of it has been done with the method called 16S, which takes the ribosomal RNA gene that’s ubiquitous in bacteria, and then it amplifies that, and then you get your sequencing data, but it does miss a lot of stuff. It doesn’t go down to a species level, and there’s just a lot of noise that surrounds 16S. So using different methodologies is really expensive.

(19:20):
It’s coming down in price now, so it’s probably more useful, but it’s still expensive. So where I would love to see it is I’d love to see similar situations in veterinary medicine where we’re actually tracking it. We track cohorts of animals across the world, different breeds, and we then are able to also track their health. And so we can actually see whether there’s a preceding marker or a flag or a change in the microbiome that actually precedes the development of any clinical disease. And to me, that’s where the magic would really happen. So if we could have it as part of our health check and we go, well, hang on, we’re seeing this shift in the microbiome, and that suggests to me that if we can intervene here, we may prolong or prevent the development of this particular disease. That’s where I think the real magic is going to come. But that’s a long way away because we need to be tracking these animals and we need to be doing all of those and correlating them to the diseases. But you talked about cognitive dysfunction. One of the cognitive dysfunction can’t talk properly. I’m getting too excited. One of the really interesting things with Alzheimer’s disease is they have actually shown that changes in the microbiome proceed any detectable change by one to two years in people. So I know like, wow, isn’t that amazing?

Dr. Andy Roark (20:49):
Well, think about, I mean, that is amazing. One of the things that we have going for us in veterinary medicine is our patient’s lifespan are much shorter, which is bad, but the beautiful part is starting to gain that type of whole lifespan knowledge. We can do it much faster than if you were following cohorts of people that started in their twenties and age into their eighties and nineties. So anyway, this is super exciting. If people want to learn more, do you have favorite resources? Are there places that you would send veterinarians, nurses, even engaged pet owners? What do you like for general educational growth in this topic?

Dr. Caroline Mansfield (21:29):
Yeah, so the problem is that there is so much information coming out. So if you put microbiome in, you’ll have 25,000 hits. So sometimes I think there’s almost, there is almost too much information. I do find the Purina Institute Center Square, they’ve got a lot of really good resources. They’ve recently had a microbiome forum, which I think it may still be available online and the recording, which don’t quote me on that. So I think that breaks it down and it also breaks it down quite nicely into bite-sized pieces that are good for speaking to clients about particular conditions as well. So I think those resources are really good for more general nutrition. I think the WSAVA, the World Small Animal Veterinary Association has some amazing resources. So nutritional toolkits and diet history forms. They also run some modules on nutrition, which are free, which I think are really useful for techs and new grads to do as well. And then I guess it kind of depends on what condition you’re talking about, then you kind of go more specific websites. But I think those are probably good places to start.

Dr. Andy Roark (22:55):
I love that. I’ll put links to the Purinas Institute Center Square in the show notes. If the Microbiome Forum is still up, I’ll link to that as well in the notes. And then the WSAVA, I’ll definitely link to that. And their nutrition toolkits are excellent and their nutrition modules as well. So I’ll put links to all that stuff. Caroline, thank you so much for being here. I thoroughly enjoy talking with you. Where can people find you online if they’re interested in you and your work and just kind want to keep up with you?

Dr. Caroline Mansfield (23:24):
So at the moment, I’m working at James Cook University, which is in far north tropical Queensland. So JCU Vet, it’s probably the best link for that. It’s a pretty cool place to be. It’s just right near the Barrier Reef and get to go snorkeling and hop up and see some crocodiles. It’s pretty cool.

Dr. Andy Roark (23:47):
That’s amazing. Oh man, thank you so much for making time and being here. I really appreciate you.

Dr. Caroline Mansfield (23:51):
No worries.

Dr. Andy Roark (23:51):
Guys, thanks for tuning in today. Everybody take care of yourselves. Thanks for being here. And that’s it. That’s what I got for you guys. I hope you enjoyed it. I hope you got something out of it. Thank you so much to Dr. Mansfield. She got up before six o’clock in the morning, her time to do this podcast, and that was wonderful. Thanks to Purina Institute for making this episode possible. Thanks to you guys for being here. And yeah, that’s it. That’s all the thanks. That’s the thank and night. Thanks to me for also being here. Thanks to my dog Skipper who came and sat with me when I did the podcast, thanks to my mom and my dad. And I’m just going to fade out. I’m just going to fade out on that. And that’s where we’re going to end the episode. Thanks so much everybody. Take care of yourselves. Be well. Bye.

The 4 Gifts of Veterinary Medicine – Rotate Your Dogs

by

In this episode, Dr. Andy Roark and Jamie Holms revisit an old article on balancing happiness, stability, and giving in vet medicine. They reflect on changes in perspectives over the years, discussing the evolution of these core principles while exploring the intricate facets of happiness, intentional giving, and the dynamics of optimism and realism in the veterinary field.

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

LINKS

https://drandyroark.com/the-4-gifts-of-veterinary-medicine/

Dr. Andy Roark Resources: https://linktr.ee/DrAndyRoark

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: https://drandyroark.com/store/

ABOUT OUR GUEST

Jamie Holms is a chicken mom and the Administrative Manager for Dr. Andy Roark, and the 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 am here with a one and only Jamie Holms. We’ve been digging through some old articles of mine. Boy, she was digging real deep at the bottom of the bag to pull out an article that I wrote back in 2017 called The Four Gifts of Vet Medicine. This is an episode that came up or an article that came up talking to my good friend Dr. Sarah Boston recently. And then Jamie also was around and kind of pulled it out for looking at, and anyway, it is a really, I hope is a good discussion. I thought it was a good discussion. It is all about balancing, giving happiness and stability in our careers and what does that balance really look like. And then Jamie was asking if my thoughts on are those really the three drivers? Have I changed my mind in the last six years? And so we talk about that a lot. So anyway, it’s a really fun conversation. I hope you guys will 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 back to the podcast, Jamie Holms. How are you?

Jamie Holms:
I’m good. How are you Andy?

Dr. Andy Roark:
I am really good. I always loved doing episodes of the podcast with you. I heard really nice things the last time you got together. We did the choosing the rulers that we measure with, and I got a lot of nice notes about that and they were like, you should do more episodes with Jamie. And so I thought, you know what? I think that’s probably true.

Jamie Holms:
Oh, that’s kind. I think that that I like to dig in and get a little deeper into your articles than you have the opportunity to do. Because an article, it’s not a book.

Dr. Andy Roark:
No. Yeah, correct. It’s, it’s funny, I have heard that people struggle to fill like a thousand or 1200 words and I not, I struggle not to write 5,000 words.

Jamie Holms:
Yes. Yeah.

Dr. Andy Roark:
They’re like, what is this? And I’m like, it’s the article. And they’re like, you’re supposed to have the back page, Andy. Not the whole article, the issue.

Jamie Holms:
Not the whole magazine. Yeah, exactly. Well, I was looking back at the way back machine. Are you ready?

Dr. Andy Roark:
The way back machine? Yes!

Jamie Holms:
Yes, the way back machine. We’re going to go all the way back. I think it’s 2015 if I’m not mistaken.

Dr. Andy Roark:
Oh wow. That’s way back!

Jamie Holms:
It’s way back. But this is an article that I know both Sarah Boston and I really love that you did about sled dogs. Do you happen to remember this article?

Dr. Andy Roark:
I only remember it because Sarah Boston, she is a onco surgeon, a veterinary onco surgeon and brilliant. She has a podcast called Co Medicine, which is supposed to be comedy and medicine squ together. And so she had me on and she specifically asked me about it and I was embarrassed. I was like, Sarah, I have very, very limited recollec. I remember an article, I said minute, then I had to go look at it. So I have actually recently looked at it. Oh, fantastic. Only because she caught me. Only she caught me flatfooted.

Jamie Holms:
Yeah. Well, I mean it was, what is that, seven years ago? So I think there’s a little grace to be given there. It reminded me of the story of the Indian elder who was telling a child that who was having some trouble with emotional regulation and they were like, how do I deal with this? And the wise man says, you have two wolves inside of you and you have the anger and you have the goodness, and the one that you feed is the one that survives. And I have always thought with that, and you know me, I have that duality of mind where it’s like it’s right or it’s wrong. Only one dog survives only. We’ve only got one sled dog that’s going to make it to the end of the Iditarod. And you have to choose which one it is.

Dr. Andy Roark:
How many dogs do you have right now, Jamie? I

Jamie Holms:
Have two. And only one’s going to make it.

Dr. Andy Roark:
Only one’s going to make it okay. No. Okay. Alright. Just checking. Yeah. Poor Biscuit. Yeah,

Jamie Holms:
Poor Biscuit. Poor Biscuit. She’s being, I just got a puppy and he’s about 15 weeks old and he very much wants to bite her on her ears and she does not like her ears touched. And so the biting on the ears is not working out real great for her. She does not like it. And he’s like, maybe if I try again in five minutes it’ll be okay. We’re like, no, she doesn’t like it.

Dr. Andy Roark:
Yeah, got to keep checking in persistent. So anyway. Okay, so there’s two wolves. I do like it. It’s the one that you feed.

Jamie Holms:
Yeah. Right. Well yours is about the sled, which is life and the three dogs are giving happiness and stability. And I wanted to go back and first of all ask, do you still think that there are three sled dogs or have you found any others? Because it’s been seven years and we’ve grown and changed in vet Met. So do you think there’s more sled dogs now?

Dr. Andy Roark:
Oh wow, that’s such a good question. It was funny. A lot of times I look back at articles to see where I was in my life and what was going on. And so this was clearly a time and when I was seeing a lot and I was probably feeling a lot of just giving and giving and not you write the article or the book you need to read, which, but I was seeing a lot of burnout. I think the idea is that there, so when I wrote this, there’s three dogs. There’s happiness, which is you taking care of yourself, and then there’s stability, which is kind of financial security. It is you making a living, getting your needs met and then there’s giving, which is you doing for other people? Clearly. I think I was feeling it this time and I was seeing a lot around me of people who they just give and give and give and give.
I said in the article, the most common dog to get starved is personal happiness. A lot of people who they’re like, I have to take care of my family and I have to take care of my team and I have to give to the world and that’s all I have to do. And the big thing is, where are you in this? This has got to work for you. And they’re like, oh no, I’m sacrificing myself, my happiness. And so I think I saw a lot of that. I think I was thinking about the dogs. I think it’s a lot of it is how much I think if I could walk it back, if I wanted to parse this part now in my new for where I’m now, I think I would probably parse happiness into other things. So I do think that there’s giving, and I do think giving is important and intentional giving matters.
And I think I understand a lot of times when we see commentary on social media or out in the world, it’s reactionary commentary is people are like, they’re responding to anger or pain. And so when they say pet owners stop asking us to do these things or stop, I don’t know, stop treating us like jerks, you think, is that really the relationship you have? And it’s like, no, they’re responding to something. It’s not. If you really met them on a calm moment, ask them, they would have a much more robust response. But we’re seeing this emotional reaction. So anyway, I think for a lot of these things when we start talking about giving or start talking about happiness or we’re talking about stability, I think that we’re leaning into this really kind of narrow view of what that is or it’s coming from a place of reaction.
I think if I was going to parse ’em apart, I think happiness is kind of a loaded word and I think that it’s still that balance is key. You know what I mean? Yeah. I think I would probably lean if I was going to do new dogs now, I think interpersonal relationships would be, I think I’d probably parse the happiness into interpersonal relationships and come out how to say it, but basically what I need to recharge and or feel satisfied by. And so I think that those are different things. And so I would say you should still be driven by giving and you should make sure that your needs are being met. And at the same time, I really have become a big believer since 2015 or 2017 or whatever, I’ve definitely become a much bigger believer that our interpersonal relationships really matter. And I think that you kind of put family in there and I think you put colleagues and friends in there and do you know people? Are you taking care of those relationships or are you head down just doing work, paying the bills, things like that. And a lot of us I think are very lonely because we forget about those relationships. And the last part is are you getting what you need out of this? Are your needs being met? So I think if I was going to do it differently, I’d probably split it into four. I don’t know. What do you think? Am I missing something here? It’s hard to rethink it, but I’m glad you asked.

Jamie Holms:
I really like what you said when you said intentional giving because I think that that’s something that we lose or we feel like we’ve lost. And you and I have talked a lot about agency in the past, but I feel like we vet med feel like we don’t really have control over what we give or how we give it because when someone says, Hey, there’s a c-section, can you stay? You often don’t have an actual choice, especially when morality gets involved in and we get stuck in that trap. And so we feel like we don’t have an option. And that’s one thing that I have some friends who work for an organization and one of the things that they say repeatedly is I get to do this. And I love that because it reframes it and it’s an option of I get to do this. And I think back to I was a phlebotomist and I worked at an organization, it was a tiny group called the Lab and they were really small and I got to do things like do blood draws on people in their car when it was inconvenient for them to come in.
And I got to do things to help people be less afraid. And I worked with a lot of elderly and a lot of individuals who had a lot of needle phobia and I basically had free reign to do whatever I needed to do to make those people comfortable. And some of it was white coat syndrome, like don’t come into the building because into the building just is too scary. And the company was bought out by a large organization with a lot of rules and we weren’t allowed to do those things anymore. And it really put me in a mindset of these things that other people were like, what do you mean we do blood draws in the car? And then all of a sudden they were like, we got to do that and now we don’t get to do that. And so I think that that’s an interesting way to look at it. And I think that you can use that intentionality with both stability and happiness. And I agree with you, I am not a big fan of the word happiness.
If I had the choice of being happy for the rest of my life, I would not choose it. I want joy, I want wonder. I want these things that feel deeper and bigger. And I think that we have the capacity through vet med. We see some of the worst things, but we also get to see some of those amazing miracles where an animal pulls through that you never thought was going to pull through or a family. You get to see generations of a family come through with their pets. And I think we’re definitely blessed in that way.

Dr. Andy Roark:
If you dream of doing team training with your team, getting your people together, getting ’em on the same page, talking about how you guys work together in your practice, I’d love to help you. You can check out drandyroark.com and check out the store. I have two different team training courses. These are courses for teams to do together to get on the same page and to talk about how you do things. I do things, I have my angry clients course and I have my exam room toolkit course and they are both available and there to come out. Alright guys, let’s get back into this episode.
Well, there’s a lot here to unpack. So I like your point about happiness. That word has, I still use it, but I don’t like it very much. I think that we’ve kind of been sold a false bill of goods about happiness and what happiness is supposed to be. I was talking to this veterinarian who’s really deep thinker and very smart and she talked about going to counseling with her partner. And one of the things that she really struggled with is her partner’s position that happiness is not important. And she’s like, what do you mean happiness is not important? And he said, it’s just not important for me. And she says, how can that be? And she said, what makes you feel good? And he says, meeting my obligations makes me feel satisfied and that’s enough for me. If I am meeting my obligations, then I am satisfied.
And she was like, this was a real sort of sticking point for a long time and trying to understand this person who was her partner and she had to really work on it. And I got to tell you, I’ve thought a lot about this and I do. I of get where a partner’s coming from? I do. And then also I can a hundred percent struggle and be like, what do you mean meeting your obligations is enough? But I think that we all know someone who’s like that and they’re like, yep, this is what I do. I meet my obligations and that’s enough. I don’t think I’ve told you this before. I don’t think we’re made to be happy. I really think that we are creatures molded by natural selection and species that are content go extinct. I think we’re made to be a little bit unhappy.
I think our default state is unhappy because that’s what makes us grow and explore and try new things and spread out and take action and hunt for food so we can have a nice little chubby layer when the winter comes. I think if we ate a little berry and we were good for the day, I think we’d starve the death in the wintertime. So we’re made to be unhappy. And so if happiness is the goal, then I think that we are always feeling like we’re failing. I don’t think we’re supposed to be happy. And so I thought a lot about that. I want to jump back to your, I get to do this and say, oh, I frame this up and I get to do this. And it’s funny when you were talking about you did this thing and you went out to the car and you did these things to sort of accommodate these people and then that was taken away.
I can’t help but think about the open hospital concept where the pet owners can go wherever they want. And I know you’ve got experience with that, but I think for a lot of people they’re like, that’s terrifying. But I can also see that if you did it and you got comfortable with it, you would recognize or you probably take pride in the fact that you say, yeah, we have people come back here, they can see everything. I think I could see myself very quickly as part of become my identity of going, yeah, we do everything in front of the pet owners. I think the only thing that scares me is what if I mess up? But I would be fine. I would be fine and it would take some time and I would practice and get comfortable and after a while you get comfortable doing things on display.
And I know that that’s true. Having not done it, I think it’s still scary for me, but I think that I would come to love it and then if I had to stop do it, I would feel it was taken away. I wrote this piece recently. I’m just curious, I’ve not talked with you about this, but I’m curious what you think about it. I’ve been thinking a lot about optimism and happiness and kind of what this really looks like given where I’m in my life. And so I’m in my late forties at this point. I can see 50 from where I am. Same. My wife had breast cancer a year ago and she’s fine. Everything’s gone well. But that was a significant thing in my life and I know you’ve seen and had things like that as well. And the whole just choose happy. I still think that every day you get up, you can decide if you’re going to be happy as a default or if you’re going to be upset or angry or cynical or afraid as a default.
I think you can decide what I’m starting out at happy and I’m to try to hold on to happy and that’s the choice that I’m going to make. I don’t think that’s toxic. I don’t think that’s discounting of anything other than I’m going to try to do this. And so I do think that there is value in optimism. I like looking at the world with an optimistic view that things are going to get better, I suspect. I think wonderful things are going to happen. You said you wonder and joy. I think looking at the world and going, there’s things out there that are amazing and wonderful and I’m going to find them and I can’t wait to see where this day goes. I think that that’s good. And at the same time, the world is a hard place. And when you live through disease or pain for family members or people that you care about, you can’t lie to yourself and be like, I’m just going to choose to be happy about everything.
And I think that that’s a paper shield and I don’t think it really works, and I don’t think it’s honest. So I went looking for insight on happiness a long time ago, and I really do like some of the Buddhist ideas. And a religion is 5,000 years old. They got some things figured out. And the Buddhist say, and it’s funny because I’ll see people and they’re kind of shocked because I have this reputation as Mr. Positive and the guy who loves fat medicine. And then I will stand in front of people and say things like, what life is suffering? Life is suffering and you should own that. Or I’ll, I’ll say, medicine is really just picking your poison over and over and over again. And they’re like, this is the positive guy. This is the funny guy that we came to laugh with. And oh, there was another one that I really like.
There’s a psychologist named Stutz is his name. He’s got a documentary with Jonah Hill, but he said this thing that I have loved and picked up, but he’s like, no one. And I mean, no one can escape uncertainty, pain and constant hard work. And I’m like, that’s awesome because it’s true. And it’s just like, yep. And the number of times I’ve been like, Andy, you’re never going to be comfortable. You are never going to escape discomfort for any significant period of time. You’re always going to be uncertain and you’re always going to have to work your tail off. If you just accept that, then you can go on. And so I think that that clear-eyed, pragmatic look at the world and what it is and what it means to be human, I think that’s also important. And so bringing this all the way back around, I have been thinking a lot about the balance in those two mindsets is can you hold onto clear ride pragmatism? Nothing in this world is guaranteed except hard work, uncertainty and discomfort. And I think tomorrow’s going to be a good day. And I think that there were wonderful things that are happening and there are people that I want to know better and there’s time to be joyful and opportunities for me to explore and do things that I’m excited about in the time that I have. And those things, I think to some people, they feel contradictory. You can’t choose happy and believed life is suffering. And I would say yes you can.
It takes some balance and perspective, but there’s nothing wrong with that. I don’t think they contradict as much as a lot of other things I have to hold in my head to be a veterinarian.

Jamie Holms:
True. Absolutely. I completely agree. I have often been pegged as being pessimistic, which I have wholeheartedly disagreed with most of my life. I’m like, I’m a realist. That’s how I see myself, because I don’t think everything’s going to turn out badly. I couldn’t keep going if I thought that. I believe that things are going when things are hard, I believe that this too shall pass. It’s going to get better. And it’s a season and you don’t have any idea how long your seasons or your droughts or your rains or your amazing harvests, you don’t have any idea how long they are going to be. And so you enjoy the things. And I was looking at, oh, you shared with me some pictures not very long ago. And in there

Dr. Andy Roark:
The nature photographs?

Jamie Holms:
And in there were ones that were pictures of natural disasters. And so one of them was a picture of this field that was just covered in snow and it was so beautiful. And the person who took that photograph was there in the middle of this terrible snowstorm and was like, you know what? That’s gorgeous. That’s gorgeous. And it’s just like, it’s beautiful.

Dr. Andy Roark:
That’s awesome. Yeah, I love that. What comes to my mind is I went with my family and we went to Phoenix as a Christmas trip a couple of years ago before the pandemic, so it’s probably been five, six years now. And so we went there and we were going to go up and go up to Monument Valley and look at all the places and go to the Grand Canyon and everything. And we did, and it snowed on us. It just dumped snow. And I remember at one point being in this lava field and it looked like Mars. You know what I mean? There was nothing really growing in this area. It was just this weird rock and also this beautiful snow on top of it. And I took tons of pictures and they do not do justice to what was there. But I think that’s amazing about incredible nature photography is the ability to actually come close to doing justice to something that’s out in nature.
I cannot do that with my iPhone, you know what I mean? I’m always very excited taking pictures and then later on I’m like, this does not convey what was there. But anyway, but it is that mixture of beauty. I’ll also say that about you too, is you and I have known each other a long time. You are my first employee. You are one of my best friends. You are a realist. I would fight with anybody who says that you’re a pessimist because you are a realist in that. Well, you do. The number of times that I have frantically pitched you an idea, and Jamie, just walk with me, look at what could be possible and we could do this. And you have been like, let’s, you know what? Let’s go for it. There’s so many times that no one can say you’re a pessimist because I have walked you into way too many adventures that you didn’t have to go on.

Jamie Holms:
That is very true.

Dr. Andy Roark:
But you are a realist as well, because Which is good because a lot of times I’ll be like, we get too thiss. And you’re like, I have questions, Andy.

Jamie Holms:
So many questions.

Dr. Andy Roark:
I have so many questions about how this actually goes down. I think we’re good for each other, but I would say you are not a pessimist. You are a realist who wants to be an optimist. That’s what I get from you. Yeah. I think I’m an optimist who wants to be a realist. That’s what I want.

Jamie Holms:
Yeah. That’s where I think that makes sense. Well, I mean that’s the balance, right? So that’s how we find it. Okay, so I have one more question about this article.

Dr. Andy Roark:
Okay, I forgot about the article. Yeah, let’s talk about that.

Jamie Holms:
Have you ever been on a sled sled? Never. Never. Oh my God. I want to do it so bad. So bad.

Dr. Andy Roark:
I have buddies. I have one friend in particular who somehow got involved with the Iditarod when we were in vet school, and he’s just been doing it forever. And I’m like, I might as well go to Mars as to the Iditarod. I’m like, this is just, it’s something like I can kind of get my head around it, but I have no idea what it would actually be. And I see the pictures and I watch videos, and I’m like, I am so out of my depth here. Well, I want

Jamie Holms:
To be real clear. I do not want to do the Iditarod. I want to go for maybe a mile and then have a Starbucks, but I want to do it. I want to do it. I have heard it’s amazing, and I love the feeling of flying, and I imagine that that’s what it’s like. And I love the excitement of the dogs.

Dr. Andy Roark:
I could get into that. I want to create a new sport called Hover Sled, and it’s a sled, it’s like a hoverboard, and then dogs can pull it in Florida in January, or I don’t know, California. We could find an area that’s 70 degrees Fahrenheit, 20 degrees Celsius, beautiful. And then they could pull the sleigh without the blistering cold. That seems to be required right now, like roller sled. We could just have basically, I want to tie dogs to a shopping cart and ride around that. That’s what I’ve decided.

Jamie Holms:
I’m pretty sure that’s already a sport, but I’m not sure if it involves dogs.

Dr. Andy Roark:
I think I’m going to investigate that. That’s what I’m going to

Jamie Holms:
Go do. You go do that and I’ll just hang out with Allison and

Dr. Andy Roark:
We’ll, well, I mean, I’m coming for your two dogs because only have bad dog, skipper Roark, who I do not trust to pull my shopping cart alone. Sure. So I’ll be over soon.

Jamie Holms:
Okay, sounds good. I’ll see you then, Andy. Bye.

Dr. Andy Roark:
See you soon. Thanks. And that’s it. That’s what I got for you. I hope you enjoyed it. I hope you took something out of it. Thanks to Jamie for being here. Thanks to you guys for being here. Take care of yourselves, everybody. I’ll talk to you soon.

Choosing the Rulers We Measure Ourselves By

by

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.

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

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.

The Daring Release of Perfectionism

by

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.

NOMV: From Facebook Group to Industry Power

by

Dr. Shannon Emmons, practice owner and member of the NOMV board of directors, joins Dr. Andy Roark to discuss the rapid growth of Not One More Vet (NOMV) and the mental health and wellness programs they have been developing.

This episode is brought to you ad-free by CEVA Animal Health!

LINKS

NOMV.org

Race Around the World

NOMV Lifeboat

NOMV Anti Cyber-Harassment

NOMV CLEAR Blueprint

NOMV Advocates Program

NOMV Gala

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

Shannon Emmons DVM is a graduate of Atlantic Veterinary Class of 2017. She is a small animal veterinarian practicing in southern Maine and the owner of Eliot Veterinary Hospital.

Shannon first got involved with NOMV after her own mental health struggles and worked to start the NOMV Ambassadors Committee. She is the Education Committee Co-Chair and a member of NOMV Seacoast. Shannon joined the NOMV Board of Directors in 2023.

EPISODE TRANSCRIPT

Dr. Andy Roark:
Welcome everybody to the Cone of Shame Veterinarinary podcast. I am your host, Dr. Andy Roark. Guys, I got a good one today. I am here with Dr. Shannon Emon. Shannon is a, she is a practice owner and a practicing veterinarian in Maine and she is a member of the board of directors for Not One More Vet or NOMV as they’re commonly known. She’s here today talking about and all of the initiatives they have rolling out and boy, they have a lot of ’em. If you are still thinking of NOMV as a Facebook group, this is going to be a big fun episode for you because they have a ton of initiatives that are coming out and we hit some of the highlights, not nearly all the stuff they have going on, but I’m really interested in what do we do about supporting mental health and wellness in the vet profession?
And they are putting their money where their mouth is, they are doing the work. They have a lot of programs coming out, is a really interesting download on all things non being what they have going on. Guys, this episode is made possible and brought to you ad free by my friends at Ceva Animal Health. They are partnering with NOMV on their Healing Broken Hearts Initiative. This is a joint wellness program they have with where they are giving 5% of Cardis sales to NOMV Card is a drug for heart failure. If you’re unfamiliar with it, I’ll put a link in the show notes to a previous episode that we’ve done on Cardis and what it is. But yeah, it’s thanks to them for one, for doing the work and supporting NOMV and thanks to them for supporting this episode and making it possible. Guys, let’s get into this.

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

Dr. Andy Roark:
Welcome to the podcast, Dr. Shannon Emmons. How are you?

Dr. Shannon Emmons:
I am good, Andy. How are you?

Dr. Andy Roark:
I am so good. I feel like we almost could have done this podcast in person. For those who don’t know you, you are a practice owner in Maine. What part of Maine do you live in?

Dr. Shannon Emmons:
Southern Maine. Yeah, let’s… you won’t know where I’m from.

Dr. Andy Roark:
It’s not Bar Harbor in Maine. I that’s, that’s where I was. I just got back last night. I did the family vacation. We went to Bangor and then a Bar Harbor and then up to Nova Scotia and PEI, which is where you went to vet school.

Dr. Shannon Emmons:
That’s where I went to vet school!

Dr. Andy Roark:
School. I know. And so I was just like, I was looking at your bio and I’m like, gosh, Shannon, she’s like Visa. She’s everywhere I want to be. And so anyway, it’s a joy and a pleasure to have you on the podcast. You are a practicing vet. As I said before, you’re on the board of directors at NOMV, which is Not One More Veterinarian. And I wanted to get you on today to talk a bit about NOMV, there’s not many organizations that I have seen that have grown as fast or has branched out as much as Novi has. And I don’t know that a lot of people understand what all Novi is doing right now. And so just to kind of set the scene, my first interaction with the, Not One More Vet group was a Facebook group, which was great, but it was a very big, very raucous Facebook group about mental health and wellness in veterinarians. And that’s kind of how it imprinted in my mind. And I was just kind of shocked recently at how inaccurate that is as far as the depiction of NOMV. So lemme just pause here and ask you, why don’t you give us a little bit of background about NOMV and your path to the board of directors?

Dr. Shannon Emmons:
Sounds good. So NOMV started in 2014 after the death of Dr. Sophia Yin. Nicole MacArthur, who is a vet, was really blown away that we as a profession have such a high rate of suicide. And she said, if I don’t know about this, I’m sure there are other people who don’t, and how can we get resources to everyone or just check in on everybody. So the Facebook forum started and I graduated in 2017 and it was cool to watch because as I joined the Facebook forum, I was seeing the need for, we were doing GoFundMe for fellow vets to try and raise money for their inpatient therapy or they needed help and then it got nonprofit status and it just blew up. And even since I’ve been involved, I started working with Novi in 2021. We’ve put on a couple of huge new programs in addition to a lot of already existing programs that we’ve been able to continue to grow.
So I started after my own mental health crisis, I had a friend reach out and say, Hey, I want to figure out how we can get NOMV locally. And I was like, that’s great. I could have used someone locally. And so I talked to Carrie Journey and she said, Hey, we’re already working on that. So I joined as part of what’s called the ambassadors program, and we started making local chapters. So there are NOMVa chapters popping up all over the us. We have one in Canada now and we have one in Brazil. So that was kind of my baby for a while, was getting that up and running. And it then led me to the education committee,

Dr. Andy Roark:
Which I want to jump in here. So tell me more about that. What does a local Novi chapter actually look like? So I’m a veterinarian. I’m here in South Carolina. If there was a local Novi chapter, what does that mean? Do they have meetings? Is it a meetup? Help me get my head around what practically is that?

Dr. Shannon Emmons:
So it’s whatever the community needs really. We have guidelines for what you can and can’t do in terms of you can’t talk badly about people or something like that. But we have groups that do. Texas is our definitely by far biggest chapter. Mallory Preston, who’s in charge of that, has really done a lot of webinars and Texas is a huge state, so they’re not meeting in person a lot though they have, they’re doing a lot of webinars, meetings with local people and whether that’s educational or whether that’s walking through a guided meditation, our chapter, so I helped formed NOMV New England. We are helping with the NOMV Gala, which is going to be in Boston in October. So we’re doing some CE there. We’re going to be doing an outreach event there. And we’re also helping with the five K in. And we did a veterinary appreciation event. And all of the chapters have really made their own takes with it, which is really great to see because it could be as simple as just getting people together for coffee or going for a walk, or it can be a big organization, however people want to do it, what the need is in their community. But the big thing is that there are people available locally if somebody needs help.

Dr. Andy Roark:
Yeah, I love that. I’ve always felt like when you’re trying to run something that’s a national program, getting people who are inspired on the ground and giving them the autonomy to do the things that they’re excited about or they see a need for, I think that’s wildly underrated as far as how to set up an organization. I’ve always seen it be very successful and it just for something like nabe where you obviously have people who care a lot about mental health and wellness, giving them a platform and just sort of saying, Hey, figure out what’s going to be helpful for the people in your area and make it happen. I think I love that flexibility. I think a lot of times you can come up with things that are prescribed that don’t really meet the needs of individuals. They might work in one place, but it’s not what other people are really looking for.

Dr. Shannon Emmons:
It’s been great to see people be able to do what their community needs and get the help into their communities, whatever that may be. And they’re at local conferences, meeting vets in their area, they’re doing local events, and it’s been great to just build that community from an organization that was largely virtual. And that’s like what you said, people know Novi for the forums, but they don’t realize just how much else there is to Novi and the help that’s available rather than just the Facebook groups, which are great. And we’ve expanded off of them. There’s the support staff group as well. And I think one thing I would love for everyone to know is we are not just for vets, we’re for everyone in the vet profession.

Dr. Andy Roark:
That was a big point of growth for you guys for a long time. It was just veterinarians and it was kind of a pain point. There was support staff and paraprofessionals and things. Yeah. So when did you guys start having groups for the support staff?

Dr. Shannon Emmons:
I will be honest, I’m not sure exactly the year on that, but I believe it was just a couple of years after everything got going because we really needed support staff to have help too. I mean, everyone in this profession has a hard time. We all have our different battles we have to deal with on a day-to-day basis. So making sure, and then students too, we branched out to vet students because and vet tech students, it’s not easy to go through vet school or tech school and to make sure those people have support as well was something that we decided also needed to be taken care of.

Dr. Andy Roark:
About how many chapters are there now? So switching back to the ambassadors, what are we talking about?

Dr. Shannon Emmons:
I believe there are nine now. So it’s always a little bit of a process just because we have to go through volunteer onboarding just so that we make sure people are adhering to Avi’s guidelines in terms of talking about suicide in a healthy way, making sure people are Q P R trained, which is the suicide prevention training. So anybody who gets involved with NABI has to go through that process. So we really just launched the chapters about a year ago and we’re excited that, I mean, Brazil is awesome. We’ve already got an international chapter, which is incredible and we keep having people apply too. It’s just a little bit to get them up and running. So I think that’s our big pausing point right now. But we keep getting the interest and we keep getting the people who are, like you said, really excited and really want to do things in their

Dr. Andy Roark:
Communities. How can people find out about chapters around them if people are interested in trying to get their own chapter going or getting involved with the Ambassador program? And how would you advise people to get involved?

Dr. Shannon Emmons:
So there’s, NOMV.org is going to be our best resource for all things. And there’s a list of our chapters and each chapter has a Facebook group, which is not necessarily a private Facebook group, I should say, a Facebook page where they post whatever they want to, whether it’s ways to support one another, local events that they’re doing. And then each chapter also has their own email address. So right now I’d say go to the page, see if there’s anyone local and if there’s not, that can be you. Yeah,

Dr. Andy Roark:
I love it. Cool. Talk to me about the things that you guys have started expanded out into. So I talked to Brian Bwin on the podcast not long ago about the non-clear blueprint, which I think is fascinating for workplace wellness. It’s a great program I’ve thought a lot about since I had him on to talk with him. But yeah, lay out some of the other things that you guys are doing.

Dr. Shannon Emmons:
So yeah, clear is amazing and has been really exciting in the past year since we started that. Another one that’s newer is called Lifeboat. It’s an anonymous peer-to-peer support group. So for the people who don’t like the Facebook forums or aren’t on social media, it allows them that same one-on-one support and mentorship and can get them in touch with the help that they need. And it’s completely anonymous. So that’s been a really great new program that we’ve gotten a lot of use of. And I know one of our former board members just mentioned she was at a conference I think two days ago and someone said Lifeboat saved their life because somebody was able to get the help that they needed.

Dr. Andy Roark:
So is this sort of a standalone webpage as well? I guess

Dr. Shannon Emmons:
It’s on the Novi website, but then you get iNOMVted into, we’re very careful about anonymity. We’re very careful about who gets into veterinary things. You hate to think about it, but the public can hold things against us in ways we don’t necessarily always expect. So we’re very careful about who can get in and who can be involved. But they get in, they’re assigned a person. If you want to be somebody’s mentor support, you can also enroll for lifeboat. And there’s resources in there on how to talk to people about certain subjects and what to do if this is happening. And it gives you the resources to be able to help. And we know that I’m not a mental health professional, I’m a veterinarian. So there is always that if you don’t know what to do, there’s always a way to find the help that you need, whatever that may be. And lifeboat gives a lot of opportunities for education in that regard. But again, if you need the help, you can get in there, get matched with somebody, and then start talking.

Dr. Andy Roark:
Okay. You said the public can hold things against us. Tell me a little bit more about what you mean about that, because I’m curious about the challenges that Naves faced. Obviously it’s a delicate balance when you’re trying to help veterinarians who are in practice facing mental health struggles and things, but beyond that, tell me what you meant when you said that.

Dr. Shannon Emmons:
So I’ll talk about another program while I’m talking about this, but we just recently formed the Anti Cyber Harassment Task Force in light of M V M C had the huge cyber bullying attack last year where they took an owner’s surrender in and it ended up going all over the world. It ended up being

Dr. Andy Roark:
The huge thing. Yeah, that was a nightmare.

Dr. Shannon Emmons:
So I’m local to them, and so I was really invested and rare breed, who owns M V M C said, what can we do to make sure this never happens again? Or at least if it happens again, we had the resources, how do we get people the resources? So we’ve had to be careful with that too, because we don’t want the general public who could potentially come back and use this stuff against us to have access to the resources. We’re trying to offer veterinarians, veterinary practice owners to combat cyber harassment. So there’s always and there Facebook groups that are attacking vets and there are always those groups that just have to be the negative in the world and start stuff that is so inappropriate. It’s great. You’d be blown away by the stuff that we do with sometimes.

Dr. Andy Roark:
No, I can imagine. I’ve been around the old social media internet world for a while. I can imagine. So I’m curious, so when you think about the future, do you think about health and wellness in vet medicine? How optimistic or pessimistic are you when you look at this? Do you feel good about the progress we’ve made in the last 10 years? Do you feel like we have big challenges ahead? Talk to me a little bit about, because you get up every day and you go into practice and you do your stuff and you step up and you’re set an ambassador for your region and you’re on the board of directors at NOMV. Talk to me a little bit about the headspace that you get in when you think about where things are going as far as mental health and wellness in the vet profession.

Dr. Shannon Emmons:
I think we have dueling pros and cons and it’s hard to say just kind of how things are going to go because I think we as a society are starting to value mental health more, which is amazing. People are talking about it. There’s less of a stigma. People are asking for mental health days off. People are asking for the time that they need, whatever it may be. But then we get the pushback too from business owners of like, Ugh, they’re complaining about having to work 40 hours a week or whatever it may be. So there’s that kind of push and pull. And then there’s the lack of veterinary professionals. I think the shortages that we’re all dealing with. I mean, I’ve been hiring for an associate for a year and a half, and I know clinics that have been hiring for years. And if you look in our area, everyone’s hiring for a vet, everyone’s hiring for techs.
And that I think is hard because those of us who are still here are taking on all that extra burden. And as you know with Covid, it didn’t get easier. We saw that huge increase in pet adoption rate and where did all of the vet staff go? So that’s my biggest concern. But I think that as NOMV continues to grow and we continue to make these programs that make Vet Bed more sustainable, the more we talk about it, the more we make people aware of ways that they can get the help and they don’t need to suffer through a bad job or they don’t need to worry about cyber harassment if we can take some of the load off. We’re trying our best to do that from every angle.

Dr. Andy Roark:
Yeah. What are you most excited about when you look at NBE and you look at all the things that are coming out in the next, say five years, you’re looking ahead and you go, this makes me smile, or this makes me happy, or this makes me feel really positive.

Dr. Shannon Emmons:
We’re planning a Novi conference. It’s in our five year plan to have a Novi conference, and we’re going to do a little baby conference at our gala this fall. So it’d be nice to just dip our toes in the water, but I would love for us to have a way to get people the mental health resources, like come to this conference, we’re going to make it mental health friendly. We’ll probably do half days and then take it easy the rest of the day. It’s still very early in the works. We have no concrete plans, but I am really looking forward to that and just meeting the people in our veterinary community. Every time I speak, every time I go to a conference on behalf of nafi, hearing how much we’ve done for people, it means that what we’re doing is important and it’s helping and it just definitely makes me want to keep doing what I’m doing.

Dr. Andy Roark:
Yeah, that’s fantastic. Real quick, I’m going to let you shout out any other programs you guys have coming up. Anything else that you’re working on that you feel like people should know that either has come out recently from NOMV or is in the pipelines that people should be looking for?

Dr. Shannon Emmons:
I think the big thing that’s coming up that I would like people to know about is our race around the world, which is virtual, but we also have an in-person option this year. So it’s during the month of September and we are just promoting Novi and General Public awareness, making sure people know what we are and do it with exercising, which is good for our mental health. And it’s one of our biggest fundraisers for the year too. So you can join as an individual virtually in person. You can start a team. My clinic competes with a clinic up the street every year and we’re already trash talking one another, get a little competition going, it’s all in good fun, but it’s whatever you want it to be. But I’m really excited that we have the in-person race, which is going to be at our gala in Boston on October 7th, and we have Temple Grandin coming to that. So that’s very exciting and we’d want to thank everyone who helps our organization on a day-to-day. Siva in particular is currently running Healing Broken Hearts program where they’re donating 5% of car Dallas sales, which we super appreciate and we have so many other great sponsors who help us to do our work on a day-to-day basis because without them, we would not be able to do so much of what we do.

Dr. Andy Roark:
That’s fantastic. I’m going to put links in the show notes to all the stuff we’ve talked about. I’ll mention the Clear blueprint Brian was on recently talking about it. I’ll put links to information on that as well. novi.org where you can find the Ambassador program information, all the things that we talked about, the lifeboat links, I’ll put all that stuff in the show notes so everybody has it. Are there any other links, Shannon, or resources that you think people should make sure to check out or be aware of?

Dr. Shannon Emmons:
Novi List is on the website, so basically anything I’m saying to you can get from the website, but Novi List is kind of like Angie’s List, but for veterinary professionals. So if somebody has a therapist locally that they’ve really liked or a lawyer they’ve locally really liked, it’s a great way to find local resources. I’ll send you to the link to the Race Around the world, sign up and to our gala registration.

Dr. Andy Roark:
Sounds great. I’ll put all that stuff into the show note. Dr. Shannon Emmons, thank you so much for being here, guys. Thanks for tuning in and listening. Take care of yourselves, everybody. And that’s it. That’s our episode. That’s what I got for you guys. I hope you enjoyed it. I hope you got something out of it. Thanks to Shannon for being here. Thanks to Novi for all the work they’re doing for our profession. Thanks to Siva Animal Health for making this episode ad free and for their Healing Broken Hearts initiative gang, take care of yourselves. Be well. I’ll talk to you soon. Bye.