Dr. Peter Weinstein joins us to talk about some of the major mistrust we are seeing in veterinary medicine. In this week’s episode of the Cone of Shame podcast, Dr. Andy Roark and Dr. Peter Weinstein discuss how the lack of trust has emerged in the veterinary industry due to the influence of media and the current state of our country and culture. They take a deep dive into the origins of this mistrust, what can be done to address it, and their hopes for the future of the industry. Let’s get into this episode!
You can also listen to this episode on Apple Podcasts, Google Podcasts, Amazon Music, Soundcloud, YouTube or wherever you get your podcasts!
LINKS
Dr. Peter Weinstein on LinkedIn: https://www.linkedin.com/in/pawdr/
Veterinary Ownership Advocates: veterinaryownershipadvocates.com
Dr. Andy Roark Exam Room Communication Tool Box Team Training Course: https://drandyroark.com/on-demand-staff-training/
Dr. Andy Roark Charming the Angry Client Team Training Course: https://drandyroark.com/charming-the-angry-client/
Dr. Andy Roark Swag: drandyroark.com/shop
All Links: linktr.ee/DrAndyRoark
ABOUT OUR GUEST
Dr Peter Weinstein is a husband, father, pet parent, veterinarian and leader. He has been involved with virtually all aspects of veterinary practice from a 15-year-old kennel kid to a hospital owner. Organized veterinary medicine has been a passion as well with various roles and leadership and presidencies of Southern California VMA, California VMA, and Vet Partners. He is a published author, most notably of the E-Myth Veterinarian-Why Most Veterinary Practices Don’t Work and What to Do About It. Currently, he is teaching business and finance at the Veterinary College of Western University of Health Sciences. He likes to think of himself as a free-thinking change agent and disruptor who, because he has a daughter who is a recent graduate from veterinary school, is working for an even better veterinary profession in the future.
EPISODE TRANSCRIPT
Dr. Andy Roark: Welcome everybody to the Cone of Shame veterinary podcast. I am your host, Dr. Andy Roark guys, I got a great one today. I’m here with my good friend, Dr. Peter Weinstein. And if you don’t know Peter Weinstein, you’re in for a treat. He’s a little bit hard to explain. He is a, he’s a veterinarian. He is a former practice owner.
He has been the Practice Management Speaker of the Year at VMX before. He teaches all over the place. He teaches vet students. He’s been a mentor of mine since I was a vet student. He is a veterinary educator and disrupter are his terms. And I think that’s fairly accurate. You’re going to hear some heresy today.
You are going to hear some ideas that are outside of the box. You are going to hear some some, he’s going to poke, he’s going to poke some sacred cows. And it is an interesting idea conversation about the trust bank that we have with our support staff, that we have with pet owners and and we get into generally declining trust in society overall.
If you have the feeling that we don’t trust people and people don’t trust us like they used to, this is going to be a great episode for you. So we really get into it when we talk about it. Let’s get into it.
Kelsey Beth Carpenter: (singing) This is your show. We’re glad you’re here. We want to help you in your veterinary career. Welcome to the Cone of Shame with Dr. Andy Roark.
Dr. Andy Roark: Welcome to the podcast, Dr. Peter Weinstein, thanks for being here.
Dr. Peter Weinstein: Dr. Andy Roark, always a pleasure to see you, hear you, speak to you.
Dr. Andy Roark: I love having you on the podcast. We– I’ve had you on a number of times and I always have just these fantastic conversations. I reached out to you recently and I was like, hey Let’s get back together. I want to talk to you about some stuff. What are you really excited about? And you immediately said, Oh, we have trust issues in vet medicine.
And I thought, okay, this is, I have thoughts on what this means to me. And it was really in line with some things I’ve been looking at and seeing. But let’s go ahead and just sort of open this up there. Peter, what do you mean when you say we have trust issues in veterinary medicine?
Dr. Peter Weinstein: It’s multifaceted. I think we have trust issues with our teams at times. I think we have trust issues with our clients. And I think veterinarians as a profession really have a hard time trusting people. And I don’t know why I can’t really explain it, but I really do think that we have maybe created a wall or a thick skin around ourselves.
It just– we were skeptical, cynical, and I, maybe I’m cubbyholding everybody when I shouldn’t be generalizing, but, it feels at times that we really have trust issues.
Dr. Andy Roark: Yeah, I, so let me give you, let me give you a theory and see what you think about it. So, I think that as a society overall, we are getting increasingly cynical. And I think modern media is a huge driver of that. I think tribalism is a huge driver of that. I think social media particularly is a huge driver of that.
I think we’ve just got a lot of in group, out group things going on where it’s like, Don’t, you’re with us or you’re against us. And if you don’t believe what we believe, you’re one of those people. And there’s just, there’s a lot of people who don’t trust that news source. Those people are lying. That’s fake news.
And it’s just, that never used to be the case. And it’s just, it’s constant. So one is, I think that there’s this media push that has really made a lot of us cynical and deeply mistrusting. I think that when we see things on social media, I think that there is one of the quickest, so there’s four big drivers of social media that I saw recently, it’s it’s negativity it’s just that full straight on, it’s extremism.
It’s in group, out group language, and then it’s emotional and moral language. And so, those are the four big drivers. And if you think about those four drivers: negativity, tribalism, emotional and moral language, and extremism. None of those bode well for the status quo. None of those help us have any sort of trusting relationships.
They’re just, they’re all driving towards these extreme views. And I think that’s, I think that’s, I think that’s really a problem. And the last thing I would say is, I really think in the last 8 to 10 years, we’ve had a massive degradation of trust in institutions in our country, whether it’s law enforcement, whether it’s the Supreme Court, whether it’s corporations, whether it’s anything like that. There used to be this general idea that these institutions were good and at least try to sort of look out for people and that, that’s not the perception that a lot of people have anymore.
And so I think that there’s, when I look at this, I go, I don’t know that anybody trusts anybody like they did 20 years ago. So does that kind of jive with what you’re thinking? Do you think that medicine is even more extreme than that or that it’s different?
Dr. Peter Weinstein: Thank you for joining me on the podcast today, Andy. But,
Dr. Andy Roark: Thank you. Sorry. I get excited about this.
Dr. Peter Weinstein: I know, no, I’m kidding. No, I think you did a great job of giving an overarching view of the polarization of our country. You know, it used to be that the gap was the sidewalk crack between different beliefs. Now it’s the Grand Canyon. I don’t think veterinary medicine is any different than any other of the global issues that you talked about.
I think we are embedded in it. So you feel it more. And so when you know, you talk to staff members and you do a lot of talking to staff members, you educate staff members. They’re not always sure that they can trust the manager or the owner. To a degree, some of the national corporations have not necessarily strengthened trust within the practice modalities because they have approached a profession that is built on relationships and made it somewhat transactional. I think we have an economic environment right now, globally due to inflation, and within the veterinary profession, even more bloated inflation because the cost of care continues to grow.
That has violated a trust with pet owners who are seeking a relationship, and we’ve had a profession that has always been very high in the respect categories that I do think the cost of care has become a problem and violates trust from that standpoint. And I think in many ways because the cost of products has gone up so high, we start to question our relationships and our trust, even with industry.
So I think there’s a, we’re living on an, a fault line with all of these things, and then you throw, as you talked about social media and the news. And I’m not sure that there’s much difference between social media and the news and I keep asking where’s Walter Cronkite. Now you probably weren’t born yet.
Dr. Andy Roark: I remember Walter Cronkite. He was, I was eight years old and he was on TV.
Dr. Peter Weinstein: Well, very good. So you know, where is the real news? Where is the factual news and I think a lot of even in veterinary medicine we expound on opinions because it’s emotional. I mean, we have become so hyper. I like to think of veterinary medicine as a demyelinated nerve. We are so hyper reactive and so easily stimulated by just the smallest thing.
We go off on clients, they go off on us. So that’s what I meant by trust issues. It touches on everything. that you brought forward as national issues because that’s how we are influenced. I mean, we’ve got five generations of people working in our veterinary hospitals. And we have five generations of clients, all of whom have different backgrounds, knowledges, and tools and resources they go to learn from.
Dr. Andy Roark: Yeah. I, so there’s a lot, there’s a lot there to unpack. It’s funny, I’m interested if you sort of agree with this. One of the things that I think has strained trust inside of individual practices is the move towards corporatization. And I’m not trying to be anti corporate at all here, other than to say there is something innately stabilizing.
Maybe when the person who owns the business is right there, shoulder to shoulder next to you, and you can turn to her and say, Hey, Dr. Smith can we talk about this decision? Or can I ask you why, this is what we’re doing, you know what I mean, and just, and knowing Dr. Smith and saying the organization has made a choice and the organization is really Dr.
Smith and we have lunch together and it’s sort of, I don’t know how you can ever bring practices together and not necessarily have that. If you don’t have that owner in the building with the rest of the people, it seems like you’re always going to have to work to try to create organizational trust that was much easier to maintain when people were there.
Now granted, if Dr. Smith is toxic and terrible, there’s, you know, there’s, already no, no trust, but does that decentralization of ownership. Do you think that is part of why we see, I don’t know, does that make it harder for teams to trust the practice they work in?
Dr. Peter Weinstein: I sold to a corporation. And so for 15 years or so, I had a mom and pop organization, me and staff and management that when there was an issue, they could come to me and say, Hey doc, the dryer is broken. What do I need to do? And they didn’t have to run it up the flagpole or we need to, you know, look to hire somebody.
And it didn’t take. You know, three memos, two texts and a carrier pigeon to get a decision made. Now you own a business too, and you have a team. And when there are issues that arise, they can go directly to you. If somebody bought you and you had to go to somebody and say, well, I want to give Maria a raise. I’m not sure we can fit it into the budget this year, but she’s really committed to the practice and I’m afraid we’re going to lose her if I don’t do that. And they say, well, if it doesn’t fit into the budget, we can’t do it. What position does that put you in with Maria, for example. So I do think. I mean, corporate influence is still a very small percentage of the practices.
It’s a large percentage of the employees. But I think we have lost a little bit of that culture that comes with a legacy owner in a mom and pop organization that’s part of the community that can make a decision to pivot. God, I hate that word because we used it so much during COVID, but that we could change.
We can morph on a dime and not have to run things up to get decisions. So I would agree with you that sometimes we lose relationships. When we lose, when the hierarchy becomes too vertical.
Dr. Andy Roark: Yeah. We have this thing called recency bias, right? Where, the things that are happening to us at present seem to carry much more weight than things that happened to us in the past. Do you really think that our with industry— so you mentioned, like product purchases and things like supplies– do you think that our relationship with industry really is different now than it was 20 or 30 years ago? Or were we complaining about prices going up in 1990 just as much as we are now, but it feels more. You know, real. It feels more. It feels more. I don’t know. We’re very much feeling the current changes and we’ve kind of selectively forgotten that. Oh, yeah, this is how it’s always been.
Dr. Peter Weinstein: Well, this is how it’s always been. But I think our nerve endings are rougher. I think we’re more reactive and less responsive. I think we had, I can go back to when I opened my hospital, which was 30 years ago, and we built relationships with our vendors. And I think to a degree, maybe the pandemic impacted it because the vendors couldn’t come in and continue that relationship.
And they were kept out in the parking lot as were our clients. And maybe a lot of this feeling is because of that three to four years of pandemic period that where we were, our relationships became there was a barrier. There was a wall between people. And I also think there’s been a tremendous amount of turnover in industry that has diminished our ability to build relationships.
Veterinary medicine is a relationship industry. We have a relationship with our staff, we have a relationship with our clients, we have a relationship with vendors. I spent more in my practice with specific vendors because of that relationship. And I let certain did not lead certain vendors in because I couldn’t stand them enough to want to have a relationship with them.
I think some of what the pandemic did, and I think it did it to your kids. I think it’s done it to other businesses, and I think we see it in all service industries is that we have started to lose that loving feeling. And it’s become transactional in many ways.
Dr. Andy Roark: So let me sort of ask you a question is sort of a cynicism test of Peter Weinstein.
Dr. Peter Weinstein: Guaranteed.
Dr. Andy Roark: I, just don’t even need to ask the question, just
Dr. Peter Weinstein: No
Dr. Andy Roark: All right. So, so I wrote this, article on a couple of weeks ago and I put it out because there was this thing on, on social media and this guy was, you know, raging about the cost of vet services and he was specifically talking about the markup of diagnostic prices and he was just really upset and this thing got a lot of attention. And of course, I really love your demyelinated nerve example because the vet community really flared up at this and being criticized this way and I do this criticism is unbearable It’s unfair and I’m not going to get into it more than that.
But what he was saying, in my opinion, was it did not make sense. It was not fair. but he was very adamant and, people respond to that. So, so I wrote this piece and the, I was telling my brother about it and he kind of laughed and and he said, you know, Andy, I’m a lawyer and I’m having a hard time
getting too worked up about the fact that there’s a random person bashing your profession online. Like, you know that’s just imagine being a lawyer and I thought about that because my brother is a great guy He’s a good person his he does end of life planning. So he writes wills which is like I mean, he’s very much a relationship person and a wonderful person and if he cared about what the general populace thought of lawyers, he would, there’s just, there would be no end to it.
There’s no out. And so my question to you, the cynicism check here is, Peter, do we even care or should we even care what the overall perception of our profession is? Or are we going to a place where like the lawyers, we have a service and it’s a vital service and, you know, people just, crap on lawyers all the time, and we don’t look at that.
Auto mechanics. I had to go get my 60, 000 mile checkup and, I did not have warm, fuzzy feelings about the car dealership, but I paid the bill and I went on and I’ll probably go back for 90, 000 miles. You know what I mean? is that where we’re heading or do you think that there’s a different path?
Dr. Peter Weinstein: I think first of all, I don’t want to become the look like lawyer, because you know as Shakespeare said, “kill all the lawyers.” But I don’t think– I think we are hyper reactive. I mean you’ve– I’ve probably written and I know you’ve written comments about the online reviews that come through Yelp and Google and everything else and how many clients bash us from that standpoint. And I know, and, you know, you haven’t been in practice as long as I have, well, you’ve probably been in practice longer since I haven’t been in practice in a while, but it’s our reptilian brain that has us remember every negative experience that we have. And so we are so hyper reactive. Somebody said, what should you do with on negative online reviews?
I said, don’t respond to them. Have somebody else could screen him for you because you will never sleep again at night with one negative online review, because that’s how sensitive we are as a profession. And it’s what it’s good about us and it’s bad about us. So, when this doctor goes on a tirade because of our markups for lab, it shows a variety of different things.
It just shows a lack of understanding and knowledge about the business model of a small business versus an industry that is run by the insurance companies and big business. But we reacted to it very personally. Each and every one of us took it to heart as if it were us. And it’s not us. It’s, a, it’s just, that’s the way we are.
And part of it is because we, and you asked me how I want to describe myself earlier, and I said as a disruptor and an advocator and an educator, we as a profession haven’t really done a great job of being cheerleaders for ourselves. We don’t go out there and rah about veterinary medicine and talk about all the great things we do.
We spend a lot of time being defensive instead of being supportive. And so I, I really do think that when we can bring a group together as came together online to defend ourselves, I think it’s a great thing. And, I do think that, we should be doing it before the fecal material hits the oscillator and you know, take and do a much better job of advocating for ourselves because nobody else is advocating for us.
Dr. Andy Roark: Yeah, I really like that. That’s– I really like that answer. I, that’s, that is, to me, that is a strong pushback against cynicism. I really like this. We’re going to take the bull by the horns and, and start to explain to people and continue to explain to people what we do and why we do it.
I like that a lot. I wonder if that is going to inform this next question. So I had this as, you know, you start talking and we talk about a trust issue. And you have been, you’ve been kind of retired for a while now. You’re really not good at retirement. Like you are, you’re really the worst person at retirement I’ve ever seen.
But you’re, but you, but your daughter is a veterinarian and a fairly recent graduate. What is your advice to her? Right? Because she’s coming into this. And so, you know, I, it’s funny, I was looking at the Merck well being study pretty recently. And that, I don’t think that thing gets enough attention for what it is.
But it really highlighted that, that young doctors fairly recently out of vet school, are the doctors who often struggle the most in our profession. And then, I don’t know whether you get, you know, crotchetier as you go along, or, if, enough people leave and the only ones left are the people who are kind of dead inside. I don’t know but given that she’s a young doctor, what advice do you give to her?Like, what’s the action steps for her? What’s the takeaway?
Dr. Peter Weinstein: Well, as somebody who’s dead inside.
Dr. Andy Roark: Fellow dead inside doctor.
Dr. Peter Weinstein: My advice to her and a lot of it comes with confidence and most of our recent graduates don’t graduate from veterinary school with a lot of confidence. There’s a lot of imposter syndrome that we propagate throughout the veterinary education model. And so my comments to Brooke, who’s in Australia practicing is, you know, you’re going to have hard times, but don’t take them personally.
And she had a questionable first job didn’t really get the support she needed from her owner mentor. And she’s been doing some per diem work as she waits for some visa updates. And they’ve been very supportive and very positive and very complimentary. But what do you remember? we tend to remember the negative stuff.
I mean, that’s a natural reflex from that standpoint. So I think it’s important, and I was interviewed for something else recently, and I think what we need to do, you and I, and all the other veterinarians who’ve been out in private practice, is we need to get into the veterinary schools and have a greater voice to the veterinary students about what to expect
after graduation. I think– I don’t think that we have given a lot of the veterinary students a knowledge enough about what life is after graduation. And I do think we should be teaching. I teach at Western. I do a lot of VBMA talks as do you, but I do think that we need to be in there advocating with the students about here’s, how to deal with some of these challenges.
And I agree with you. The Merck study is good. I think a lot of it points out to the financial challenges as a cause, cause for the issues. And the financial challenges stem from client communication. And they stem from cost of care and they stem from clients declining services from that standpoint.
And they also deal with salaries as well as student debt. So there are so many variables. this is a multivariate, very complex veterinary profession with very sensitive people who are demyelinated nerves, being unsure how to deal with negative outcomes and a negative outcome is a review. A negative outcome is a review from a client.
A negative outcome is a review from a boss or a manager. A negative outcome is even just, you know, how long it takes to get through the day, and we don’t How many freaking professions, Andy, get to play with puppies and kittens all day? I mean, do you want to be a proctologist and stick a tube up a dark hole? Do you want to be a dentist and look at the other end and see the proctologist at the far end?
Dr. Andy Roark: No. Yeah. I, I, say that all the time and I walk into the exam room and the pet owner says, how are you doing? And I just say, this is my job. I mean, how could it not be great? And I they, like that. It’s what they, it’s what they want to hear. And I, but, and I do believe it. Let’s imagine for a second that the profession is a ship.
The profession is a ship and you get to put your hand on the rudder. So, so that sort of, if I could sort of steer the profession as a whole. What would you do in the next five years to try to address the financial concerns or this financial stress? Because you’re spot on. Inflation is going up, you know, much faster in vet medicine than the general population.
And I agree. I think pet owners are not dumb. They see it. You know, we all see prices going up at the vet clinic and we all hear comments about it. I don’t know what the immediate fix is, but if you had the professional rudder and could actually steer the profession as a whole, what would you do? What, would you try to see, or what would you like to see in a way to try to relieve this pressure?
Dr. Peter Weinstein: Wow, I feel like I’m dealing with a cat bite abscess and I’m just waiting for the pus to come out. I, just, and I was quoted on this not that long ago, probably six, seven, eight years ago, that veterinary medicine would be great if we had socialized veterinary medicine.
Dr. Andy Roark: Mm hmm.
Dr. Peter Weinstein: Where you and I as veterinarians could go into an exam room. And for a small co-pay, go in and provide the care, the best care that the pet needed. And the client would just be able to receive the care and the medications and everything else at a reasonable cost. And we could be doctors, and we could educate.
I think education is an extremely important aspect of veterinary medicine. And everybody who’s listening to this, when you graduate from veterinary school, you go from student to teacher. And every time you walk into the exam room, every time you go back into the treatment area, every time you get on the phone, every time you hit the keyboard on your computer or your phone, you’re a teacher.
And so I’m digressing for just a minute, but socialized veterinary medicine. So we, and with that, we as veterinarians would be paid a fair and equitable salary for the work that we do, but we don’t have to talk about the cost of care, how much less stressful would that be from that standpoint.
Dr. Andy Roark: Oh, yeah.
Dr. Peter Weinstein: Now clients could still choose to go to a PPO and we could have PPL practices out there as well for those clients who wanted it. And we could look to see how we could subsidize things more with companies like Care Credit or some of the pet health insurance companies from that standpoint. But I just think a lot of our stressors come from self value and clients who are declining services that you know would be beneficial to the pet.
And, they’re declining it for two reasons. One, they can’t afford it. And two, they don’t understand it. And there’s probably some other things in between. But I think it’s our failure to clarify the why, behind the what of everything we do. And that’s the biggest difference in the last 20 years. Andy is, because of the internet, clients can get all sorts of dis-information that forced us to talk more about why we do everything we do. When we used to just be able to talk about what we need to do.
So I’m all for socialized veterinary medicine. Now it’ll never happen, but if we could do that, would be one thing. let me continue my thought process if I can, for just a minute. I think that there has to be a way to subsidize the cost of veterinary education through more scholarships.
So that when veterinary students graduate, they have a one to one debt to income ratio so that they’re not at 250, 000 in debt or 180, 000 in debt and a salary of 120, 000. And I think there needs to be some more subsidization. And this is where I touch on industry as well and other resources. So we can take some of that out of the picture.
And I think we need to look in our business models as to what we can do to improve our efficiencies. So we can keep our profitability where it is, but be able to not continue to escalate the cost of care to clients. Which to me is one of the biggest stressors is not being able to provide optimal patient care. Because the cost is in the way and knowing that pet is not going to receive what it really needs.
Dr. Andy Roark: Dr. Peter Weinstein, thank you so much for being here and talking with me. I really appreciate it. You have a new course online that I just saw. It’s a program that you have for entrepreneurs. It’s for people who are interested in starting practices, things like that. Tell me a little bit about that and where people can find it.
Dr. Peter Weinstein: Well, Andy, thank you. Thanks for the opportunity, A, to be on the podcast and B, to talk a little bit about one of my passions. As you and I have spoken since you were just a baby in veterinary school. For those of you who don’t know, I knew Andy before he knew himself. I have a big passion for independent veterinary hospitals.
I do think there’s a definite place for corporations in the veterinary profession, but I would really love to see the growth of entrepreneurship. And so Dr. Dan Markwalder and myself created a program. He’s one of the voices on the recordings. We created 24 hours of race approved CE that basically take you from soup to nuts or from finding a location to looking for a new location after you’ve grown your practice.
of online education. It’s in forty-seven 30 minute modules that you can watch at the convenience from your home. And we call it Veterinary Ownership Advocates. And really what it’s focused on is people who are looking to buy a practice, looking to do a startup or even young entrepreneurs who already have their practice up and going, and they’re trying to find more information about how to do things.
And so, the website is www.veterinaryownershipadvocates.com all spelled out. Yeah, I should have found a smaller URL, but so veterinaryownershipadvocates.com. And it’s really focused on helping stimulate entrepreneurship in the veterinary profession. And it includes monthly mastermind calls where we will meet with the members of the veterinary ownership advocates community to talk about some of the issues, problem solve, and share best practices. And so, it can be focused at veterinarians, it can be focused at practice managers, it can be focused at technicians, but anybody who is looking to and interested in being a hospital owner.
Dr. Andy Roark: Gotcha. Cool. I will link all that up in the show notes where people can find it. Peter, thanks for being here. Guys, thanks for tuning in. Take care of yourselves, everybody.
Dr. Peter Weinstein: Thanks, Andy.
Dr. Andy Roark: And that’s it. That’s what I got guys. I hope you enjoyed it. I hope you got something out of it. Thanks to Peter for being here, guys. If you enjoy conversations like this, maybe you should try out my newsletter. I have the Dr. Andy Roark newsletter. You can sign up at drandyroark.Com. It’s totally free. I write for it every week.
And so, I often think about these types of things and this is not kind of the stuff I write about there. And so anyway, like I said, it’s totally free and I write for it every week. If you’re interested in it, go over to drandyroark.com and check out our free newsletter. Anyway, anyway, guys, thanks for being here.
Take care of yourselves, everybody. Goodbye.
