Dr. Jessica Vogelsang discusses the latest findings in veterinary retention and attrition. She is joined by Dr. Andy Roark as they dive into the American Animal Hospital Association’s new white paper, “Stay Please.” Together, they explore both expected and unexpected insights gathered from a survey of over 15,000 veterinary professionals. Tune in to discover the reasons behind the departures and commitments of veterinary professionals, and what these trends could mean for the future of 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
AAHA White Paper: https://www.aaha.org/practice-resources/research-center/white-paper-form-the-path-to-increasing-retention-in-veterinary-medicine/
All Dogs Go to Kevin by Jessica Vogelsang: https://www.amazon.com/All-Dogs-Kevin-Everything-Veterinary/dp/145555491X
Jessica Vogelsang on LinkedIn: https://www.linkedin.com/in/jessicavogelsang/
Uncharted at HiVE in Minneapolis: https://unchartedvet.com/conflict-management-training-navc-hive/
Dr. Andy Roark Exam Room Communication Tool Box Course: https://drandyroark.com/on-demand-staff-training/
Dr. Andy Roark Swag: drandyroark.com/shop
All Links: linktr.ee/DrAndyRoark
ABOUT OUR GUEST
Dr. Jessica Vogelsang is a noted veterinarian, internationally recognized speaker, and bestselling author of All Dogs Go to Kevin. She serves as the Chief Medical Officer at AAHA and is the founder of Pawcurious Media, established in 2009. An early adopter in utilizing the internet for veterinary purposes, she successfully built an online community, influencing hundreds of thousands of pet owners globally. Her achievements include launching several veterinary brands and founding the Veterinary Telemedicine community during the COVID-19 pandemic. Besides her role at AAHA, she is an active board member of the Mark Morris Institute and the Veterinary Virtual Care Association.
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 the one and only Dr. Jessica Vogelsang saying she is the chief medical officer at the American Animal Hospital Association or AAHA as it’s often called. She is here talking with me about a new white paper that AAHA just published.
Put it, put out, it’s called, officially it’s called Stay Please. It is a retention attrition survey about why people leave the profession, why they leave the clinic. Are they thinking about leaving the clinic in the next year? And are they thinking about staying? If they’re staying, why are they staying?
What makes them want to stay? And so we have this really nice conversation about why people leave the profession and why they leave their clinic and then why they don’t leave and what matters. And so it’s just sort of the tip of the iceberg, but I think it’s a really good conversation to start thinking about what people care about and how do we keep people? How do we keep them in our practice? How do we keep them in our profession? So anyway, that’s what we’re talking about. It is a good time. 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. Jessica Vogelsang, how are you?
Dr. Jessica Vogelsang: I’m great. How are you doing?
Dr. Andy Roark: Man, I’m good. It’s so good to see you. Is this your first time on the Cone of Shame podcast? I think it is.
Dr. Jessica Vogelsang: Yes, it is!
Dr. Andy Roark: That’s amazing.
Dr. Jessica Vogelsang: I remember you back when you were doing YouTube in your basement.
Dr. Andy Roark: Exactly. Well, that’s where I’m, that’s where I’m recording now, old YouTube studio in my basement. I was thinking you know, I always sort of reflect back on when I met people that I interview. I met you in like, 2012, I think, and we were at the Starbucks in San Diego, and I, I reached out to you because I was a huge fan of you, and you were writing, you were writing your blog, Paul Curious, and this is when blogs were really blowing up on the internet and all of that sort of stuff, and it was a long time ago.
Dr. Andy Roark: It was a long time ago. It was a different world. There was no TikTok. It was all just writing blogs on Facebook. And you, you are such a wonderful writer. You, I always enjoyed your perspective so much. You have a book. It’s one of my favorite veterinary books. It’s called All Dogs Go to Kevin. And so anybody who wants kind of a fun it’s, it’s fun, honest read on, it’s sort of a humorous look at, at vet medicine and you’ll sort of your life as a general practitioner and I just, I highly recommend it.
So anyway, you are now onto bigger, bolder things. I’m not saying better because I really liked your blog, but you’re on to bigger, bolder things as the Chief Medical Officer at the American Animal Hospital Association.
Dr. Jessica Vogelsang: That’s right.
Dr. Andy Roark: And I saw you recently, and I was asking you about this initiative that I’ve seen from AAHA that I wanted to kind of break down and I didn’t realize what a big hand you had in it when we first started talking.
So AAHA put out a white paper. It is a retention attrition survey. It’s called Stay Please. It is a— it is a survey mechanism for AAHA hospitals all about basically employee retention and what makes people stay and what makes people leave. And so let me, let me just sort of pause here for one second and kind of hand it over to you for a second. Tell me a little bit about the survey. Tell me about what it does. Tell me about what it was intended for.
Dr. Jessica Vogelsang: That’s a great question. During the pandemic, McKinsey put out a big survey called the great the great attrition kind of studying all the different factors that make people leave their jobs or make them want to stay. And so our CEO Garth Jordan came to us. We’ve been interested in doing some research anyway and said, what do you guys think about this, modifying this for a veterinary audience. And I said, I’m in, because what we had never seen up until that point was a survey that asks people not only why are you leaving, but asking them why are they staying? And we hadn’t split it up by job roles. So we decided if we’re going to do this survey we really need to get information from people.
What job role do you have in the clinic? And we broke it down into six different groups. And also the other thing that was incredibly important to me was to include people in the survey who left because that was the other narrative that I think had been out there was that people leave by choice. Rather than I’m really, really sad to leave and I really don’t want to.
And so we really wanted to include those people. I was really inspired to participate in the survey. When I was at the moms with the DVM encouragement conference, that’s Julie Busby’s conference that she does every year. And I was looking at this room of moms, many of whom had left the profession and
I think I had been sort of beaten down and disheartened thinking the profession doesn’t want me back. They’re not making a house that’s built for me. And that made me really sad because I’d been there too. This idea that I want to live here, but this isn’t a livable situation for me. So what can we do to make it better?
And that was really the Genesis for me of wanting to be involved in this survey. And we were so excited when we put it out, we normally get About 2 to 3,000 respondents for a typical survey. We had 15,000 people. You couldn’t stop people from responding. They had a lot to say.
Dr. Andy Roark: Yeah, that’s amazing. So I love this, I love this statement, not making a house that’s built for me. Talk to me a little bit about that. So, so that’s sort of, I totally understand. Julie Busby does a great job. Her mom’s with a DVM conference. I’ve heard wonderful things about it. Tell me a little bit more about kind of what the house is not built for me.
Did that bear out in the survey results? What does that sort of look like when you say it?
Dr. Jessica Vogelsang: Yeah, you know, I, I think and again, I’ve been out for a while, but I remember going through vet school and that there’s a certain amount of assumptions. Right? Like if you’re going to vet school, you want to own a practice and, and that’s what you’re going to do. And what does owning a practice look like?
Well, how does that bear out for your life? And sort of a set of assumptions, maybe that you’re not the primary caretaker for someone that you’re not going to have these other challenges or obligations in your life that you will always put veterinary medicine first every single time in every situation for the entirety of your career.
And if you are not able to do that. For some reason, be it temporary or permanent. you’re out, right? You’re out. And once you’re out, you can’t come back. So, so there’s this, all of these competing narratives that veterinary medicine is only allowed to be a part of your life if you’re willing to commit 100 percent to it.
And, you know, whether or not that’s true, I don’t know, but that was, that was always sort of how I felt. And when I was in situations in my life where I needed to take some time off to take care of family members because I had a baby. It was always sort of this sense of disappointment. Great. You know, another one bites the dust rather than like, cool, you know, we’ll see you in six months.
We’ll see you in, in a year when you’re ready to come back bigger and better. And so we’re doing a much better job of, I think, allowing people that flexibility and helping them see that there’s a place for them, but in my opinion, it was very hard one. It wasn’t that we have as a profession ever built that house for them. Like they had to fight. We had to fight our way back in and say, I’m still here. I still have something to give, boss.
Dr. Andy Roark: Well, it, it totally makes sense and I, and I love that this sort of inspired you to, to sort of pay attention to the voices of the people who had, who had left the career or left, left the profession or left their jobs and that, that, that totally makes sense to me. Was that bared out in the results when you look at attrition data, Jessica?
Is that kind of the feedback that you started to see? Tell me more kind of about what this, tell me more, I guess, about why people leave. Yeah. Yeah.
Dr. Jessica Vogelsang: So it’s interesting. We have the data broken down sort of as a monolith and then broken down by job roles. And so when you dig in, we had 15 different factors. The reasons people leave far and away, and this shouldn’t surprise anyone. The number one reason people leave is cause you’re not paying me enough.
You know, I, I, I can’t survive on this. And also unsurprisingly, although it was the top factor for pretty much everyone, it was the top factor by orders of magnitude for our credential technicians. And some of the, some of the things that they said in the survey, like the quotes you get back would, would break your heart.
You know, like I, I, I, I love this profession, but I have to eat. I can’t keep stealing peanut butter from the treat jar in the back because I can’t afford groceries. I’m like, Oh my gosh, what, what is wrong with us that, that we’re doing that? And so it really sort of reinforced a narrative to me that, People are aren’t leaving because I decided the field wasn’t right for me, or I didn’t love it.
I left because there is an untenable situation. So the other factors we don’t work as a team. You know, I don’t feel appreciated. The leadership isn’t caring. You know that all of those top factors are similar across job roles, just in different different degrees of importance. But it gives us a really clear blueprint for if you want people to stay, you know, here are the things that that you need to do that you need to make better for them so they won’t want to leave.
Because most people And so we, so we asked them, you know, are you planning on staying? Why are you planning on leaving? Why? And if they said that they were planning on leaving in the next year and 30 percent of the respondents said, I’m thinking about leaving and we know statistically 25 percent of them actually do 25 percent turnover in this profession across all job roles, which is huge.
But you asked them what they wanted to do, and most of them were looking for another job within the profession. Very few people were like, I’m out, you know, they were looking for either a job in another clinic, but half of them were doing that. And the other half were saying, I’m looking for a job in industry.
So people were just really, we’re tied. We’re tied emotionally to this vet profession. People don’t get into this for the same reason that people go into other jobs. Like there is a deep emotional connection to the work that we do. People find it very meaningful. And so when they leave. I think most of us are trying really, really hard to still keep a finger in it.
Now, you don’t put years and years of your life into a profession to leave after five years, but that’s what’s happening with our technicians. The average length in this field is five years. Like how that’s, that’s not good.
Dr. Andy Roark: Yeah.
Dr. Jessica Vogelsang: That’s a big problem. Well,
Hey guys, I just have to jump in with incredible news. I will be traveling with the Uncharted Veterinary Conference team. That includes Stephanie Goss and Maria Pirita we are going to Minneapolis for the NAVC HiVE conference that is there. This is on June 15th and 16th. Guys, we are doing a one day Uncharted conflict management training program.
That’s right. And it is included with the cost of HiVE. All you have to do is register for the HiVE conference that’s $99 for two days. One day, you can spend it with us, bring your team, send multiple people from your practice, put them together. We’ll put them at round tables. We will have them working together, talking about conflict management.
We’re going to take them through a whole day. This is not a series of lectures. It’s not, they’re going to go to one and they’re going to do something else. Nope. Check the box register for the Uncharted event at HiVE. And you will spend the day with us. And I guess you’re never going to see an Uncharted event that is a day long.
That is $99. Again, like this is the best price you will ever see on conflict management. So anyway, if you are anywhere near Minneapolis, June 15th and 16th, Come to the HiVE event it’s $99 and you get a day with Uncharted. If you register for it and the other day, you can use it HiVE and get their amazing CE for technicians and managers. Anyway I’ll put links in the show notes.
You should learn more. I’m serious. If you were within hours of HiVE, there was never going to be a chance for you to sign up multiple team members come together. And do conflict management training as a group. This is a phenomenal opportunity, please don’t miss it. If you’re able to make it, it’s going to be great.
Let’s get back into this episode.
Dr. Andy Roark: Were there big drivers that were role specific? So, so I totally understand that, you know, there’s basically the same sort of drivers and they’re sort of re prioritized across roles, but when you say that pay is an orders of magnitude larger concern for our credential technicians, that, that tracks to me.
Were there other items like that where you said this role specifically is being disproportionately impacted by this factor or, or was it otherwise mostly just sort of a reorganization of, of The, the general factors.
Dr. Jessica Vogelsang: I think far and away, you know, the, the pay is, is the big one. And so, You know, what that means is as soon as you get that part sorted out, right, then you have a lot more leeway to figure out what the rest of the factors are. So it’s something that was really interesting to me was when you look at retention factors the top three retention factors for associate DVMs and credential technicians, they map perfectly one to one.
This is a cohort of people who are in it for the same reasons and care for the same reasons. So meaningful work, modern medicine staff works as. And so the thing that was different was that we’re not You know, the associate DVMs for the most part weren’t saying, I can’t afford a car. You know, that’s the sort of thing that our credential technicians were saying, but their attention factors were very, very similar.
These are people that were very motivated by the same things. And the other thing that really, really jumped out to me was talking about, Your, your CSRs and, and support staff, the professional development was a huge retention factor. And oftentimes when I’m presenting this research or talking to to groups, I’ll say, how many of you offer continuing education or professional development for your CSRs?
And a fraction, a small fraction of the room will raise their hands. And so the sorts of things that we were hearing from them is it. Clearly, I’m not in this for the money. I could make the same amount of money at at a grocery store or a retail job and probably be a lot less stressful. I’m in this because I love it.
But in return, I would really love if you would help support my professional development so I can be better at my job. There’s very specific job specific roles. And I want to I want to do better. Help me.
Dr. Andy Roark: Yeah, Yeah, that, that, that totally makes sense. What is it? What do you think it means Jessica, when, when, you know, number three, the staff works as a team? Do you get inside into, like, what, give me an example of what that looks like when a staff works as a team versus when they don’t. Is that everybody is, is working off sort of a unicor–, a uniform treatment protocol?
Like we’re all kind of practicing the medicine, like, is that, is that, is that a workplace culture response? What do you, what do you think that means?
Dr. Jessica Vogelsang: Yeah. I’m so glad you asked that actually. And I swear this wasn’t a plant everyone. We actually just had a meeting about that this morning and trying to figure out how we can research that more because we were pretty intentional when we asked that we didn’t define it. And so the people who responded all had something different in their heads.
So now we sort of have a framework for the next white paper. What does that mean? Team based medicine is a very specific defined discipline specifically on the human side. And I think there are some groups in vet med that are really starting to pick at that. But we have a lot of work to do in order to define what that means.
For me personally, it’s about creating a culture that is family centered practice, right? You put the patient and their family members at the center of every decision that’s made and then everybody else is supporting that. And so everybody on the periphery has to figure out how to work together to support that as opposed to, I think, some of the ways that we maybe center ourselves right now
in, in that decision making process or how things function in the clinic. So it’s just a very different way of thinking, but we’re going to spend some time teasing that out.
Dr. Andy Roark: Yeah. That, that. That totally makes sense. I just think, I think it’s when you get feedback like that, I often say, what exactly does that it, does it look the same for everybody? So, so we’ve talked a bit about, about sort of the reasons people leave and we talk a bit about the reasons that they stay.
I, I, I love the idea that the, the vets and the techs both, both are top three are the exact same. That, that totally makes sense to me. I think, I think, you know, it’s funny with a meaningful work as number one, I see as we’ve had sort of corporate groups moving into vet medicine, and all corporate groups are different, but I have seen conflict in that way where there’s a lot of a lot of companies will use sort of operations language to try to talk to the doctors and the technicians and it doesn’t go well because they’re not here to hit your operation numbers.
They’re here for a much more sort of heartfelt purpose. And it’s just that has been a communication like conflict that I’ve kind of seen over and over again in the last couple years. So that totally tracks number one for when you start sort of looking at these things, you know, one of the things about the survey that I think is interesting is, you know, what do you do with it and where do you go with it?
Can you talk to me a little bit about, you know, I know a lot of people are listening because they’re like, well, you know, I wanted to hear about retention in the practice and what can I do? How can I assess my own practice and what can I do to try to, to try to keep people here? Can you talk to me a little bit about, about best practices?
Dr. Jessica Vogelsang: Yeah. And this is all, it’s so early stages in terms of the work that we have to do. So, you know, at AAHA, our whole purpose and mission is to simplify the journey to excellence for veterinary practices. So it’s not about hitting a mark or hitting a brass ring. It is about doing better every day. And so what we need to do and what our challenges as an organization is, again, we have this information in front of us.
What next? So how do we help people regardless of whether you’re a practice manager who wants to help their team function better or whether you are maybe a new grad trying to figure out is this, how do I figure out what the right job is for me? What questions do I need to be asking my interview? I want to build out a tool set that help people explore all of those things.
So you know what to ask for because we all know how to ask for salary right now. I think it’s, you know, at the very least we’ve done a better job at helping people ask for that. But as we know now, that’s just the beginning because there are lots and lots of people who picked a job that paid the most.
Who are wretchedly miserable that there’s other things that matter. How do you know how to ask for those things? How do you know how to determine whether or not you’re going to be able to get them at the job that you’re at? So it’s, there’s a lot of work ahead of us, but it’s energizing. It’s so energizing to me.
Dr. Andy Roark: Do you think that it’s possible to teach people that? I’ve been thinking about this a lot because, you know, when I work with practice owners and you know, they’ll be talking about recruiting or hiring veterinarians, whatever. And it sounds like so many people come with a salary number and that’s it. Like, that’s all they got.
It’s like, I don’t know what else you do, but this is the financial number. And it’s just, it’s interesting to look and to say, I’m not, I’m not shaming anybody for a salary number they come with but. But I, I don’t know that that number is really what is going to make people happy versus the culture of the place that they’re working, other things like, like time off to support the continuing education support, all of those sorts of things.
And I don’t know, it’s, it’s sort of a nuanced conversation, but I still, I continue to see people that hold so tightly to the money and I think when you jump back to what we were talking about the very beginning, when we look at the number of, one reason that people leave, I think that justifiably there’s, there is concern about money in vet medicine and what people get paid.
So again, I’m not, not trying to knock that, but I, I’ve been rolling around a lot trying to have good, productive, nonjudgmental conversations about what makes people happy and practice beyond salary. But I don’t know that there’s a good way to approach it.
Dr. Jessica Vogelsang: Well, it’s not an either or conversation, right? It’s a yes. And so you need to have a living salary and you need to have these other things. And that is part of the challenge because I don’t, you don’t necessarily know how much you need something until you’re in the middle of it. So some of that is time and experience.
I think mentorship and we have so many great programs out there that are starting to help people understand and develop that having a mentor who can maybe help you get some clarity on that can be super helpful. And one of the other things that really jumped out at me as one of the factors that we asked about for folks was flexibility.
And the only group where flexibility was a top factor in retention was associate DVMs. And you know, you can theorize about why that is, but that’s a group and I’m thinking again about the moms at the DVM group. That’s huge. Do people even know to ask for that? Is it something that you know you’re going to want in, in your job or career?
And so those are all the conversations that we still need to be having. And so how do you offer that? If you are a team, that’s really proud of what you have to offer. And because we hear that all the time, I can’t compete with the salaries that maybe another clinic in town is offering. How do you help people understand?
How do you quantify the value of the rest of it? And it’s not about, you can’t really put a dollar amount on those things. So I think we have to start telling those stories and finding those people who, at the end of the day I think meaningful work is the hardest thing to quantify. That’s going to look different for you, for me, but we have to be asking ourselves what makes life meaningful, and to me, you know, the reason that that I love being in vet med.
And the reason that every time I got kicked out, I came back, it’s like, there’s nothing else I want to do. Meaningful work to me is doing anything to honor that human animal bond. So when I was in the clinic, my goal was to make sure that that, that pet and that owner left. That that somehow improve their outcome, right?
That means a lot of different things. And there’s a lot of things that have to go to play to make that happen. And so now at AAHA, I want people to stay in this profession and find value and find meaning in it and being in an organization where I’m in. The ability to help tell those stories and elevate those conversations that is meaningful to me.
Dr. Andy Roark: Yeah, it sounds like it sounds like you have a lot of sort of next steps, you know, with this, with this program as we look at it.
It’s it And funny, you know, you and I talked about with you, what’s it mean when we say the team works well together? I think you can equally just ask, you know, what does it mean to have meaningful work?
Like, do do is that uniformly defined? I’m sure it’s probably not. But talk to me a little bit. Where do you see this going? Jessica? Like, what are sort of the next steps? Where does this research take you?
Dr. Jessica Vogelsang: Yep. So, next steps for us are starting to build out some of those, those tools for people. And so asking people, figuring out which of these things do we want to focus on first? What do people need? Who is the audience that we’re trying to give these tools to, right? And I think employers and employees both have a different set of tools that they need.
So we’re going to be talking to people and finding out what’s the number one thing that you need help with right now is understanding what understanding what teamwork looks like is a big one. So I think we’re probably going to go in that direction, helping to quantify what What their pay means.
That’s very challenging to do for a lot of different reasons. But just helping people understand, you know, we did a separate survey a couple years ago where we were asking everybody in the team. What do you think your technicians make? What do you think they should make? And what do you want to make?
And so for the vast majority of technicians, what they were asking for wasn’t like twice what they were making. They’re saying I need 5000 more. I need 5000 more, which, you know, when you look at what it costs to lose a good technician, it’s going to be a lot more than that. So even just starting with some of those basic conversations, do you even really understand what the problem is and what you need to do to solve it in the short term or long term?
So. So that’s a really long answer to a short question, but this is a lifelong, like, I could write out the rest of my career just trying to figure out what all this means.
Dr. Andy Roark: I’m going to put links in the show notes, everybody to the white paper. You’ll be able to check that out. I will link to the AAHA website just so people can can have that. Jessica, where can people follow you online?
Dr. Jessica Vogelsang: I am on LinkedIn a lot, so feel free to look me up there. I love to have conversations and talk with folks about all of these things. It’s really grown as I, because I know Andy, when we first when we first met at the Hilton or wherever that was you were just asking me how to get on Twitter. That’s how long ago it was.
Dr. Andy Roark: How, yeah, how, it’s– there’s new thing called Twitter, really interested in it. Yeah yep It was that, back in a much simpler, more naive time online.
Dr. Jessica Vogelsang: So now we’re all LinkedIn.
Dr. Andy Roark: Well, 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 what I got for you. Thanks so much for being here, everybody. Thanks to Dr. Vogelsang for being here. She is a dear longtime friend of mine.
I’m so glad to get to have her on the podcast. Anyway, guys, take care of yourselves, everybody. Be well. I’ll talk to you later on.
