Veterinarians are probably some of the most passionate and dedicated professionals. Most of them knew what they wanted to do since childhood and meticulously planned out the steps towards the ultimate goal — helping animals. So why, after almost a decade of targeted professional education and training, would only one-third of veterinarians recommend a career in animal healthcare, and 40% are considering leaving the profession? Why are so many veterinarians burned out and what can leadership do about it? Learn more about it in our webinar.
Since the webinar’s duration is limited, some of the questions from our kind audience remained unanswered. For this, speakers gave their take on these issues afterwards. You can find Josh Vaisman’s answers in his comprehensive post-webinar article. We are also happy to share Alyssa Mages’s vision of what makes veterinarians happier:
Is there a difference in happiness levels depending on the field of work, i.e. clinics, pharmaceutical industry etc.?
Happiness is subjective and personal, so yes – levels will differ depending on what field of vet med you’re in, and what happiness means to you as an individual. Does your work bring you joy? Do the people you work with contribute or detract from your happiness? We all have to ask ourselves the hard questions and look within before we can address what we put out into the world.
What’s the one thing that needs to be changed to achieve work satisfaction and how can this be team implemented?
One thing to achieve work satisfaction within a team is to invest in the people on it, and I don’t mean financially! Take the time and put in the effort to ID what people truly want and need to continue to grow and thrive on the team and then provide what they ask for. Everyone benefits when people feel that they have been seen and heard and that action has been taken towards this.
Are there any software tools that could be built that would ease a burden of vet staff?
Telemedicine is a huge time and efficiency saver and doesn’t typically require software investiture. A headset, remote access capabilities and a designated team member – veterinary nurses are primed for this! – and you’re set.
My male colleague can walk out of a room with a client still babbling on, and somehow the clients laugh it off. If any of my female colleagues or I do this, we’re labeled insensitive and a few other things. I’m tired of listening to clients, and frustrated men doctors often get away from this behavior. I know how to ‘wrap it up’ but I’m angry that gender still dictates how veterinary professionals are seen
Gender bias is absolutely an issue throughout our profession, and it’s going to take significant steps on the part of the practices as well as those of us within them to enact serious change. Education of the team on what this looks, sounds & feels like is essential. Notifications – signs, announcements, etc. – for the clientele as to what will & what will not be tolerated is a necessity. And don’t stop here, because while being a woman is certainly a challenge, there are other biases (unconscious, conscious) that must also be addressed such as racial & ethnic inequities, ableist mentalities, and any form of discrimination of those who identify as members of the LGBTQIA community. Practice owners, administrators, management & ALL team members must be held accountable for this, and that starts with each of us. Being self-aware, educating ourselves on the statistics, histories, & current events is a great place to start, but this is not a static or singular event. Equity is an evolving process, and it’s an active one that we all must fully invest in ourselves to bring about the changes we seek.
How can they do something more than just technician, like building a big company?
I’ll answer this with a question of my own, what is “just” a technician? For me, no one is “just” anything as we all play an integral, multi-faceted role within our organizations. The beauty – and the struggle – of being a veterinary technician is that we can and we do SO much! From running appointments to running lab work, taking radiographs, inducing and maintaining anesthesia, administering chemotherapy, advanced ER/CC, and handling all of the other “ologies”, there really isn’t anything we cannot do. With the exceptions of course being that we cannot perform surgery, diagnose, relay prognoses, or prescribe medications – those are for our amazing veterinarians, and I’m happy for them to handle all of that! So, find what you truly love about being a vet tech and get really good at it. Investigate what other options are out there for you – academia, specialization, research, content development – the list is nearly endless, and if you dream of starting your own business, do it. Plan it out, spontaneity in business models is usually a recipe for disaster, and find your niche. Chances are the idea(s) you have are needed, so grow them, expand your network, and get out there and do it!
Given that the industry representatives and industry bodies are made up of men, do you think that could have any correlation with the continuing failure to address the retention and mental health challenges of the profession?
I don’t know if this is necessarily a male v. female issue as much as it is a societal and potentially generational one. The stigmas against mental health, supporting wellbeing, and the overall growth and development of our industry is a problem that crosses gender lines and certainly has been around for longer than my time (17 years) in the industry. That being said, men and women do communicate differently, in that men tend to talk to share information whereas women speak in order to build relationships, so there is likely a component of gender bias involved, but it is not the sole reason and we have to ensure that we address all aspects in order to facilitate a shift and ultimately a change.
Welcome everybody. Today we have wonderful guests. Thank you for joining this series of webinars that we call Leading With Purpose and the topic “Why Are Veterinarians Unhappy?” We’re going to talk about why veterinarians are unhappy and the common problem in the industry: the talent and scarcity of the talent, and try to uncover what are the reasons for that.
First, I would like to introduce our wonderful guests today. The first guest is Alyssa Mages, the Co-Founder and Chief Visionary Officer at Empowering Veterinary Teams. Alyssa, why don’t you introduce yourself?
Absolutely. Thank you, Ivan. It’s an honor to be here. I’m excited to be hanging out with everyone today. So I’ve been in veterinary medicine since 2004, and I have my bachelor’s in Marine Biology and then transitioned over to this incredible field and got my credentials in 2012 officially.
I’ve worked all throughout the industry, lab animal to large animal, and throwing some good Marine creditors, just for fun. But my passions are truly emergency critical care and education. I found a true niche in training, coaching, and growth and development within the veterinary teams. So I absolutely love our veterinarians and I’m really excited to speak to that today, but also our veterinary technicians, nurses and assistants, those integral members of the team.
And that’s why we founded Empowering Veterinary Teams back in 2019 to really make sure that we work together to inspire, instruct and make a positive impact of the change.
Wonderful. Thank you. And then we have Dr. Nicholas Nelson. He is the Chief Operating Officer of BluePearl, which everybody knows over a hundred pet hospitals, specialty hospitals across the U.S..
So Nick, do you mind, kind of diving a little into your background and introducing yourself?
Yeah, for sure. Thank you very much, really excited and honored as well to be here. I think it’s a really important topic for our profession, it’s probably as important as ever. It’s time to actually dive into it and have a discussion, I think, unless we talk about it and spend a lot of time listening, we can come out the other side.
I’m a veterinarian. I have a Doctorate in Veterinary Medicine from Washington State University. So over 26 years now in the profession, which it’s unbelievable that it happened that quickly. I have a master’s in business administration as well.
In my current role at BluePearl, we have over a hundred hospitals throughout the country, and over 7,000 associates. I spend most of my day on the business side, but really more focused on the most important asset, which is each and every associate within BluePearl. Some of the things I’m most excited about that we’re doing is our initiatives around health and wellbeing, equity, inclusion, and diversity.
I’m really excited about career pathing and really having the profession be a place where you can have a career and not just start your career, but start it, have a middle and finish your career in this great profession. And then finally, very excited about what we need to do in our profession to really make a better world for the planet through sustainability.
Thank you for that introduction and what a wonderful way to have a broad reach like yourself for these initiatives in large organizations like BluePearl! And then we have last but not least – Josh Vaisman, he’s the Co-Founder of Flourish Veterinary Consulting, a positive psychology practitioner and culture consultant. So Josh, can you please introduce yourself?
Thanks. I appreciate it. I’ve got to say, it’s very humbling to be here surrounded by these incredible people, really doing some meaningful, compelling, and impactful work in our profession. So my name’s Josh Vaisman, after over 20 years of experience in this wonderful profession, I have this crazy idea that all that veterinary professionals really do deserve to be sustainably fulfilled by their work.
And we at Flourish Veterinary Consulting, believe that positive leadership is really probably the top conduit to make that kind of thing happen. So what we do is we take the science of human thriving, using my background in applied positive psychology and some other things, and we combine it with evidence-based leadership approaches to empower veterinary leaders with the skills to cultivate workplaces in which everyone can really thrive. That’s kind of our spiel. That’s what gets us up in the morning.
Thank you for that, Josh. And just a brief introduction of myself – I’m Dr. Ivan Zak, a vet by trade, I’ve been here about 20 years in the industry, switched from practicing as a veterinarian in ER, and multiple relief work, built hospitals, helped to sell hospitals, and then built SmartFlow, ran a software division at IDEXX and now I’m building Veterinary Integration Solutions, where I am the CEO. At VIS our purpose is finding the management methodologies that will help veterinarians to live their passion. I’m dedicating the next probably 10 years of my life, at least, to find a way to combat burnout in the veterinary domain.
So the opening problem statement that I wanted to bring to this discussion is that there are simply more pets than vets. It would be interesting to review a couple stats here and discuss how we got there.
Quite an astonishing stat: about 40% of veterinarians consider leaving the profession. They don’t want to work as vets anymore. About one third of the veterinarians in the AVMA survey would not recommend becoming a veterinarian.
And then statistically it’s about 45% of clinics in the U.S. are lacking 1.8 vets. So almost two vets are needed in half of the hospitals in the nation. And AVMA did a survey on the reasons why they don’t like their profession and are tired of it. Number one was not the money. We’re trying to throw money at veterinarians and the pay rates have grown, which is great for the profession, but it’s not the way to fix it from what it looks like from the stats.
And the number one reason is work-life balance. I know it myself because I burned out significantly when I was practicing as a veterinarian, I went through quite a traumatic experience, had to find an external help and left the profession for half a year because I couldn’t continue. So I truly know what it feels like, and work-life balance was one of the reasons.
47% don’t like their profession or the place where they work because of the culture. And only the third place is the higher compensation is something that they think would motivate them more. So I wanted to open up with those stats and just say that this is where we are at. This is what’s going on in the profession. And why do we think that’s the case? So Alyssa if I can start with you.
Sure. I think in particular, the past year, which felt like 10 years rolled into one for everyone, has definitely impacted our veterinary profession significantly. I know the curbside and transitioning to all of that, less contact, but people are at home and they’re looking after their babies a lot more than they used to.
And some may have waited or been okay to maybe not deal with this, now they’re coming in and the ERs are slammed just like human ERs. That’s not at the forefront in the news field. Right? So we don’t hear about what is all happening in the veterinary essential workers experience.
And the 10 hour days are 14. And the 14 hour days that usually happened when you did a 12 hour shift are 16. And the work-life balance is not there. And also a part of it is the isolation on different fronts. Because we don’t want to complain at work because everyone’s going through it.
And we can’t necessarily complain at home because we’re actually getting out of the house and some people aren’t, but you know, I don’t know about those of you that have significant others, but I think I totally burned my family out on hearing stories about what I had to deal with at the practice.
So it’s just flow and flow and flow. And there hasn’t been a real conversation that has evolved into action. For those wellbeing and mental health pieces, they’re only starting, you can feel momentum and the emphasis is growing, but that hasn’t really been at the forefront until the past two to three years.
And it has impacted everybody. What we do is an emotional experience. It’s not just a mental profession, it’s mental, physical, and emotional, and that takes its toll over time.
Thank you. Josh, maybe you have an opinion on that.
Yes, I think that what Alyssa is saying is incredibly insightful and, and very accurate.
I feel like the people in this profession are some of the most resourceful, resilient, capable of evolving, talented, skilled, and passionate human beings that I’ve ever met. And I think we’ve done a really excellent job of taking those resources to bear and using them to find ways to meet the needs of the animals and the people that we serve.
And that’s really awesome. We’ve done a really, really good job of doing that. And in doing that, we’ve sort of neglected as a profession, as a community, using those incredible skills and traits and characteristics to also find ways to meet our own needs. And I think that’s sort of the next step in our evolution.
I think part of the problem is that we’ve put so much of our resources into meeting the needs of others that we’ve lost out on finding ways to meet our own needs as well. And I feel like that’s sort of the next evolutionary step of the profession that we’re going to need to take to not just taper down, but really turn around this, these statistics that you saw there, all of the people that are leaving in droves, that makes sense.
Coming from a larger organization, like you, Nick, do you find that these stats are accurate? Are there more attractive ways to attract veterinarians to work for the organization? Or are you seeing any trends?
There’s not a ton, but I’m going to break it down into three pillars, or three big rocks. The first rock: the current state we had is what we’ve been talking about. But let me take a step back. When I went to veterinary school, most of us on this call today, it was purpose-driven.
We went there to make a difference. We went there to be inspired by the human-animal bond, to do right by people and their pets as part of their families. And we then jumped into the profession as a profession that needs to grow as a business. I think we’ve lost our purpose, a little bit of why we come to work every day.
Yes, it’s about the number of cases you’ve seen, the number of surgeries you’ve done. Yes, we need to be fiscally sound to be able to rebuild the profession and to create the facility improvements, the quality improvements in innovation, to give back to our people so that we can have a sustainable profession.
But the purpose isn’t a fiscal purpose, it is much more deep than that. It’s about caring for people, for each of all of our associates that provide the care, caring for them first. And knowing through that, we can give ourselves to people and their pets, pet parents and pets. So I think that’s the first thing – we have to get back to the basics and make sure that what is our purpose in each one of our hospitals each and every day across the country, whether they’re part of a larger organization or privately owned, we better refine and not forget why do we come to work every day? And let’s make sure that’s personal because being personal is productive.
Part two – let’s talk about 11+ million new pet households, already a very stressed system with not enough veterinary professionals to provide the care. And then you add on top of that, the pandemic and our clinicians, our teams, not just clinicians – technicians, customer service stars, by the way, hospital leaders, by the way, have been, I don’t know if we spend enough time talking about the pressure they’ve been under to try to keep their team alive through all this.
So I think that’s another area to look at is that they started off this pandemic with just being afraid. We kind of got through being safe. Part two then was this, I’m calling it not acute pain, but chronic pain, like a chronic headache that went on for a year with no relentless. It just kept coming, coming to come.
And I was, I was in Minnesota this week and we have an internal medicine team there. The next available appointment is June 8th. What do you think happens if their next available appointment is June 8th? They’re getting backdoored into the ER, which further stresses the system.
And where I sit today is: we need to be okay with setting boundaries. We must set boundaries. It can’t just be about saying yes to every single patient that comes through the door. We have to be okay with pausing service. We have to be okay. And that’s where the leaders have to give you permission to do that because the oath we took starts to affect us. Am I doing the right thing? How could I say no? But if we don’t say no, we’re not taking care of ourselves and we’re going to wake up one day with a profession that is incredibly fractured and the time to solve this is now. So boundaries and permission to have boundaries.
And part three is we must start talking about mental health. Talking about mental health doesn’t mean you’re crazy. No, everybody on this call today has mental health stuff. And I look at it in three areas. We must listen, we must then participate. And then we must demonstrate by our actions that we’re going to engage there. And I think by understanding purpose, making sure that coming to work has meaning to set the boundaries and being okay that we can’t be all things to all people. That’s how you’re nobody to no one.
So let’s talk about mental health. Let’s listen, let’s be a part of this because the third phase, as I said, phase one is fear. Phase two was chronic pain, phase three, where we sit today and we’re feeling it at BluePearl is what I call kind of the post-traumatic stress disorder.
We finally are sitting here and saying, well, what about me? What about my life? What about my family? What about my health? And if we’re going to really keep this industry from being fractured for years to come, that’s how I look at that question and how we start to get our ways out.
And it’s going to be a collective effort. It’s not going to be BluePearl just doing it. It’s all of us. It’s a better world for ALL. And that’s where I see that’s, that’s the commitment that I want to make. And I want to partner with other leaders to get us there.
Right. That makes complete sense. I wanted to touch on the topic of potential generational differences.
If you follow Simon Sinek, he was talking about millennials in particular, being narcissistic people with a sense of entitlement. I’m in the first year of millennials so I’m one of them. So basically with the whole technogenic generation, instant gratification, how we perceive information and basically everything that is associated with how we behave online and everything else potentially changes how people are motivated.
So this is where it’s interesting because the majority of veterinarians are millennials. So is there any difference in the generations, how they’re motivated? So, Josh, do you want to open with that?
Sure. I am not a millennial, I’m 44, but my wife is 37 and she just discovered a new phrase, which I’ve never heard before. Apparently there’s this new terminology called geriatric millennial.
So to answer your question, about generations and different modalities of motivation. I don’t think that there is a generational norm for motivation. I think that human needs are human needs regardless of the generation that we come from. And when those needs are met, you know, Nick touched actually on some of them – the need for connection, the need for relationship, the need to be heard and understood, the need for safety, the need for experiencing meaningfulness, seeing the value of our contribution feeling as if what we do and who we are actually matters in the world.
These are all basic human needs that fit everybody, whether you’re 15 years old or 85 years old. And so, you know, actually playing off a little bit of what Nick was talking about. I was listening to those three pillars, Nick and I was nodding my head through the whole thing with what it sounded to me like, was that you were talking about relationships, you were talking about taking the time to actually talk to each other, to understand each other, to hear each other, to listen to each other.
And that is what I really think about when I think about business. I think that all business endeavors, whether it’s in our profession or manufacturing – all business is relational, it’s all human there. There’s no such thing as a business outcome without a human being driving it.
I think the best way that we motivate people is try and look past the stereotypes that we may have, you know, preconceived based on their age and actually sit down and talk to them. You know, tell me about a time when, when you felt like what you did here matters. How can we help you do more of that? Tell me about a boundary that you have, if you could just increase it by 10%, and its efficacy or veracity, it would have a really big impact in your life. How can we help support you in identifying that boundary, sharing it with the world and then really honoring it.
Those are all relational things. And I think that it really comes down to more on that individual level, and finding ways to embed that in our practice, whether it’s an independent, small practice and you’re the one doctor owner. And you’re just having these conversations with everybody who works with you. Or you’re BluePearl, and you’re training the trainers, you’re coaching the coaches – the people who are on the ground, developing those relationships, you’re empowering them with the skills to do just that.
You can’t expect someone to learn the same way that I do, for instance. Nick and Josh have both spoken so eloquently that it is a relational approach. So if I’m a visual, kinesthetic person, but you like to talk things out, I have to switch my stance and meet you in the middle so it can work. And not everyone is built to be a trainer.
And the other part of that too, is I love what Josh said, that you’ve got to train the trainers and coach the coaches, but remember that we train skills and we coach people. So you have to interweave that whole process together. And I just think that’s incredible to hear that in different ways from everyone that’s sitting here today.
I have one thing to add to this is that I thought it was funny as well. I’m 51 so I’m definitely not a millennial and I’m not a geriatric millennial. I bring that up because I think the other piece to this: 61% of BluePearl clinicians are millennials. I believe that millennials actually are helping us. They’re not more prone to burnout, they’re just more vocal about what their needs are. They’re just more vocal about what is work-life balance and more vocal about my benefits and more vocal about my teammates and more vocal about how far can I go? And I actually would say that the millennials come in at an incredibly important time because we need to listen to what they want – that is the answer.
And then part two is me being in the X generation in the room, we also have to break down the past from the present. We have to find ways to find a common brand, the genius at the end, not the tyranny of the “or”. It’s not about what generation is better, who stands for what. If you really get into a collaborative conversation, each generation has something very special to give and each generation has challenges. But if we can collectively come together as leaders and build those bridges, find ways to come together to find that common ground. I believe that’s in part lies work-life balance, and then in part lies the challenges we face with not being happy, usually not being happy means “I’m not feeling heard.”
And it’s hard for me to practice gratitude each and every day, because ultimately in my life, happiness comes down to the daily practice of gratitude, and I think we have to have gratitude for each other and gratitude for differences. Discourse and differences is incredibly important to drive innovation and change.
Absolutely. So talking about the different representation of the profession, when we did this study last year on the burnout, we found that the younger veterinarians are actually more prone to burnout. We didn’t do the slides male versus female, and our profession is around 85-87% female. Alyssa, in your work with the veterinary teams, do you find that female veterinarians are more prone to burnout? Or is there any difference that you find?
Well, it’s definitely a more in-depth answer than a simple yes, that’s for sure. It comes down to the numbers. 10.9% of the entire veterinary profession is women. And then if you’re looking at more numbers and specifically to the United States, 57.2% are female, or identify as female. It’s a lot, right? The pay gap is still prevalent. There’s $5,000-10,000 in salary differences per year.
And you also have to look at the support teams too: 90% of veterinary technicians, nurses, and assistants identify as female. So with those numbers, the response to burnout and things is going to be higher. It comes at a very poignant time to ask that question, too. Definitely you’re seeing that shift, that more women are leaving the workforce universally, not just in our profession, but everywhere. So are they more impacted by it? Those of us that are mothers, I have two small humans and, you know, fur babies as well, and that adds a strain to it.
It’s definitely something different in how women interact and how we have conversations. It’s different. Yes, we should all be universally the same, but we’re not, men and women do not communicate the same way and we don’t emote the same way. It’s about that educational process too, for each other and on our teams.
So do I think someone who identifies as female is more prone to burnout? Yes. I can feel that very, very deeply and keenly, but I’ve also had dear friends that are not, they identify as male and it hits them hard too. So I think it’s very “practice to practice” and “individual to individual” conversations.
So, like I said, it’s not a simple yes or no. It’s definitely something that you can see being more prevalent due to the numbers, but again, because it’s a more commonly had conversation within that gender group.
And I guess while we’re on the topic of inclusion and diversity, how can we remove the barriers in our profession and pay more attention to that?
I’ll keep going if you guys don’t mind. Look at this incredible group of people, look at us. We all look the same. That’s our profession, the numbers again: 85% is white. I think you have to start with ourselves by being self-aware and recognizing that we need to educate ourselves and what we show up for and that we do so authentically knowing when to speak up and when to listen. This includes knowing the differences of like token hiring versus true diversity. Equity and equality are not the same thing.
There’s this amazing visual where there’s three people trying to look over a fence and they’re all different heights given the same size box. It doesn’t work. That’s equality, everyone’s given the same thing, but the shortest person needs three boxes to see, then it levels the playing field.
And then inclusion is not simply an invitation, like yeah, come to the dance. That’s great. Who’s asking them to dance? We need to break the stigmas, we have to start truly celebrating all of our differences and being a true ally, not just for the optics. You know, are you doing the work? Are you reading the materials? Are you understanding how this all started and how we are a part of the problem, but then can be a part of this solution? Making sure that we start there. Because really, we can’t do the external work if we haven’t done it internally first.
And then it’s time to ensure that all of these principles are integral to each practice’s culture. And if we’re talking in our profession, work with the Multicultural VMA, the Black DVM Network, Native American Veterinary Association, you know, Latinx Veterinary Medical Association, all of those.
And there’s still more, and I’m not trying to miss anybody, but you have to get the language. You have to be there authentically and honestly, and recognize that you have to do the work. And it’s not going to happen if you don’t put the effort in, and then you have to maintain this. First, as people are joining the team, and then ongoing team growth and development. I’m a part of a bunch of organizations that are working towards this. Self awareness is the key, first recognizing that there is a problem. And having those conversations and not stopping there, putting them into action and owning what our role in this process is and then recognizing when it’s time for us to step back and shut up and let the people have the conversation that needed to have their voices heard.
Thank you. Since the study we did and found that the industry is burned out, one of the hypotheses that I had is that veterinarians are very goal-driven individuals. Everybody that I tell that I’m a veterinarian, probably like 90% of people will say at some point in their life they also wanted to be a veterinarian. There’s a certain number of people that get there it’s a very long selective process. So I started questioning myself: if people decide to become a veterinarian at the age of 8, 10 or 12, then select that as a profession, pursue it, build a family along the way, go through college… And then they get into a vet college, finally get through this hard school, get to the last point. And the goal is over. You got it, you win. And then then they don’t set any more goals going forward. So I’ve been questioning myself: is that something that is happening in the industry as well, and maybe not having the skill of goal setting beyond that big sort of North Star that you achieve?
Could that be the reason why they burn out? Is there an answer in providing them structured goal setting? And I know goal-setting is a huge aspect of positive psychology too. So, so can you guys maybe comment on that?
I’d love to respond to that. But first I want to ask you a question. Why did you want to become a veterinarian?
Well, the go-to answer for everybody is that I love animals. Of course I do. But also I liked finding solutions to complicated problems and a systematic approach, putting a lot of facts together and identifying the problem. That was probably what drove me.
I really liked that sort of aspect of it. That’s awesome. Thank you. Thank you for taking that impromptu question. Yeah, I think what you’re touching on is for so many people, we set these big, bold, audacious goals, like becoming a veterinarian and there’s, it’s not just about becoming a veterinarian. It’s so that I can contribute, so I can accomplish this, so I can live out my strengths. Goal setting can be a really, really powerful tool to both motivation – the kind of motivation that results in what we call subjective, vitality, that feeling of a liveliness, that feeling of energetic newness and fulfillment.
We can do a much better job in our profession of helping all veterinary professionals really set and work towards and achieve impactful goals. However, we need to do a better job of making sure that those goals are meaningful to them so that they can see and experience that contribution so that they can see the impact they’re having, they can see why working towards this and accomplishing this actually matters in a meaningful way.
That is so true. It doesn’t just quantify what you’re doing, it qualifies it. It’s fulfilling. You can go and talk about smarter goals and those are absolutely important because you can have the metrics and things. And for those analytical brains folks, of which I am not, that’s vastly important. If you have something tangible that you can refer back to, like, I met this benchmark and met this benchmark and to have both of those options in place in a veterinary setting – it’s crucial for everybody on the team. You know, you’ve reached this certain tier, well, where do you go next? Here are your options, here is what we’re going to provide for you in order to have that happen. Here’s this type of webinar. Here’s this workshop. Here’s this course, here’s a guy who’s gonna come in and talk to you about how to think differently. There’s this girl that’s going to teach you how to make stuff out of the junk laying around your practice, ways to think outside of the box.
Like you mentioned, everyone here has talked about: having purpose and redesigning and reforming and rebuilding and rebranding. So why don’t we do that for ourselves?
One add. I said it previously – it has got to be personal. And I would also add one other aspect to that: we’ve spent our whole life being veterinarians, but it’s not just about goals around veterinary medicine, what about personal development?
It has to go to personal development and that can be part of the veterinary profession, by the way. There’s a lot of things around my communication style or how nervous I’m around others. Like there’s a lot of things that can really better our lives that we can use at work and also in our personal lives.
I like to look at development as 70% doing, 20% mentorship and 10% formal. And when you really look at the 70% “doing”, then it really puts the onus on the individual. And then as leaders, how do we get intentional and deliberate to really lean into our people? Because all of a sudden now, you don’t leave an organization and leave your immediate boss, and now we can make it easier to be a boss.
And I don’t like the word “boss”, I just say that in quotes, but how can we be that right mentor, that right support? That 70/20/10, making it personal and making sure that doesn’t just have to be about goal setting around the next certificate I’m going to achieve, or then it can be much more than that. It’s really about building out a more well-rounded culture of veterinarians, that isn’t just about the profession itself.
I also want to add one other thing to what Alyssa said about diversity, equity and inclusion, which I think is really important: we have to recognize and be comfortable with unconscious bias because we all have unconscious bias. Now you can take tests at Harvard right now, and it’s actually depressing some of the stuff that you get, but unless you’re willing to go there and recognize that we’re not all the same. And we really support each other on the journey to say, “Hey, you know, you need to really be my accountability partner. I’m not seeing this, help me through it, let me get through this pain.” Then I think we are going to normalize. And that’s how I think you look at equity, inclusion, diversity.
And ultimately to me, the final piece is belonging. And I want to get to a place where you feel like we belong. And the order to belong is we have to all be recognized for who we are.
We also have to recognize who we’re not and be given grace to go through the journey together because the unconscious bias is real. And that grace that we have to give each other to get through is why it takes a village and why community is so critical.
Absolutely, I’ve been practicing this in our organization, cultivating the sense of belonging. I like the Maslow’s pyramid, I know it’s not scientifically proven, but it has been a framework for some people. So I just wanted to show this to the audience and then open a discussion behind it. This is how we run it at VIS, this is how I talk to my employees.
We basically think that the goals shouldn’t be attached to money. From Maslow’s hierarchy, I considered that money is a basic need. You should be paid adequately for your training. When we hire people, we don’t celebrate that we hired someone professional cheaper than that person would get otherwise on the market because that person will leave as soon as they will find out how much they can get on the market.
So we actually try to pay what we can pay maximum for the market for that person. Physiological and safety needs – that’s money.
The next level is love and belonging, that’s your family, that’s your loved ones. That’s the people who you communicate with outside of work, but in the work environment, that’s the sense of belonging that we think that adds the culture and purpose in the organization. And then when we talk about the goal setting, and this is a segue to that whole hypothesis that I have, that veterinarians are just not good at setting new goals.
So my thinking is that if we help them to set goals in any of those directions that you guys mentioned, maybe that will help. When we just started sending out the invitations to this webinar, we got many, many comments like “ah, more KPIs, more productivity…” It’s not about that. What I’m saying is: you want to get better at ultrasound? Structure. Help the veterinarian, to say, “Okay, now I’m a vet, but I want to be better at ultrasound. Let me help you as a leader to set out the curriculum, how you get there and not just give you a thousand bucks to go to the next conference or log in on Zoom to the next conference, but structure it, set up to three year goals to get there and then help to set another one before you achieve that. So that’s something that I’ve been practicing and it seems like this resonates better with people and then ultimately they do get to that place of self-actualization and happiness.
I think it makes a lot of sense. What you’re talking about is exactly what we’ve been building up to through this conversation. It’s about personalizing it.
It’s not about tying any sort of goal to some sort of compensation, it’s above and beyond that. It’s about having a conversation, “Ivan, what’s important to you right now? What’s your next step of growth? Where’s the direction you want to go? Where do you want to be in three months? What do you want to be doing? And then how can I partner with you to help you get there?”
This is that culture, purpose, connection and belonging – making you feel like you do actually matter, your goals matter to me, I’m not just here to be your boss. I’m also here to help support you in achieving what you’re trying to achieve in career and life.
And I love what Nick was talking about, about making it truly personal. At Google, they have this wonderful thing, it’s a document called the One Simple Thing document and a lot of their managers are trained on doing this. They have routine one-on-one conversations with their reports and the One Simple Thing is often used on a weekly basis: Hey, what’s just one simple thing you’re trying to do this week? And it’s intentionally built around nothing to do with work. So you might say, well, you know, I’m really trying to get to the gym three times this week. Great. Now I, as your manager know that you’ve set that as a goal for yourself, and now I can check in with you throughout the week.
Hey, it’s Wednesday. I know you wanted to get to the gym three times this week. How many times did you get there? Well, actually I only went once on Monday and I don’t really think I’m going to have time to do it again. And now as the manager, I know this about you and I can go talk to others on the team and try and make arrangements so that actually today you do have a 90 minute lunch and you can go to the gym over lunch and help achieve that goal.
And yes, I totally agree with you. I think if we’re having those conversations, if we’re discovering what matters to people and how we can be there to support them in achieving those things, absolutely can make a massively compelling contribution to their overall sense of happiness and fulfillment.
Right. And if I could add to what Josh just said, that was really amazing. But to go back to what Nick was saying about making it personal versus professional, well, again, they’re interwoven. If we’re not developing each – ourselves as a person and then supporting that – then the profession is not going to work. It’s like mental health and clinical skills. If you don’t work on both of them, each suffers.
So I would disagree a little bit, on putting the training and the goals on the individual because I’d like to focus on the person.
Going into the clinical aspect of this, which is what I like to focus on. We’ve labeled so many of us for so long, it’s like: you’re a beginner, you’re intermediate, or you’re advanced. Well, that’s not fair. You know, I might have come from GP and now I’m in an emergency room, so it’s different, I’m learning. I’m learning, developing, and mastering my skills.
And to go through that process then, well, here’s your skill sets to do so – you’re emerging, you’re evolving and then you’re expanding. And to change the language and the conversation and how that’s approached. It’s amazing what that can do, right.
So yes. Have the conversations, make sure that you’re aware that this is a personal and a professional journey, they’re intertwined. And then that you have the correct conversations with that awareness factored into what you’re saying and how you’re saying.
Perfect. One interesting thing about the goal setting and the KPIs, because when people hear KPIs, they just go, “Whoa, you’re gonna measure me again?” And your article in DVM360 was very interesting about different types of KPIs.
I’ll start with just going back to where I started with: KPIs are so often driven to how I am going to drive the business? I’m running operations for a fairly large company and we have to be fiscally sound to give back to our people, to invest in our facilities, to create the quality advancements that are necessary. I don’t think that’s what gets you out of bed every day. And I think we need to bring purpose and meaning to life each and every day with our people.
The only way you can do that is you have to focus your KPIs around three big buckets. One and most important is your people. And we don’t really create a lot of KPIs around our people. KPIs are more often around price and volume and yes, that’s important. But what about people metrics and do we really define our people metrics that get into the hearts and minds of our people so that at the end of the day, great leaders do one thing really well: they care.
Do our people know that we care? Do they know that they’re most important each and every day? Because that’s what unlocks everything.
Two is metrics around medicine. I travel around the country right now and I say it over and over again as BluePearl is the largest provider of specialty in emergency care in the world. And with that comes incredible responsibility. Incredible. That responsibility is to ensure that we’re leading from a place of medical excellence, because that’s what inspires our people. And that’s why they chose to go down the specialty and emergency line, as well as primary care. I’m a primary care clinician myself.
The third is around operational excellence. When you put those three in balance and you share that it is around people, it is around medicine and we need to be operationally sound – it’s much easier to create a story that is real, that people will buy into. But too many times the KPIs are mostly around operations and we don’t include enough medicine and we don’t include enough people.
And if we want to have a balanced scorecard for the future, that’s what will resonate incredibly well with our people.
And then finally, we need to be personal. Being personal is productive, and we need to understand the difference between lead measures and lag measures. Ensuring that each and every associate, whether it’s a private hospital and it’s the owner, whether it’s a large organization like BluePearl, whatever it may be, – I try to share that we’re all equals here. Nobody’s more important, we’re all equals. We all have a role and an incredibly important role.
As John F. Kennedy, when he went into the janitor and said, what are you here to do? And he said, I’m here to put a man on the moon. Well, purpose that resonated throughout that entire organization that led to putting a man on the moon and we need to make sure we’re treating everybody with dignity, respect and with equality.
I love the way you put it into the balanced scorecard because we’ve been using a balanced scorecard in business for over 40 years now. And the whole definition was: let’s stop measuring the business based on the financial metrics. Yet that’s exactly what we’re doing in veterinary medicine. There’s almost zero, and I work with multiple consolidators, there’s almost zero that are measuring as a part of their productivity how well they interact with their people. Everybody says that they’re taking care of our people. How do you measure that? So what are your KPIs on people growth? What are your KPIs on feedback from your people? And you know, you can’t put KPIs on that. Running the NPS score or the feedback from the technicians that work with a particular veterinarian. There could be a surgeon that drives a couple million dollars of revenue – get the feedback from the nurses that surgeon works with. You might not get such positive feedback.
So it has to be the balance from your clients, your employees that work with each other, and then the financial metrics – that will create a balanced scorecard for the organization.
I think that’s extremely valuable, which leads to a question about the safety and psychological safety at work. The one thing that we’re not very good at in any environment and one of the huge triggers of burnout, according to Maslach, is the breakdown of the community in businesses and when there’s no candor feedback loop or training.
So Josh, that’s probably a huge part of positive psychology, the psychological safety. Can you add to that?
Yes, I agree. I want to take just a quick step back to what you were talking about and how it relates to psychological safety. You were talking about measuring the human experience in the workplace. Playing off a little bit of what Nick was saying, that that is one of your primary leading indicators.
The lagging indicators of how the business is performing tends to be as a result of the environment in which the people who are doing the work are existing. John Amaechi talks about how culture is defined by what we tolerate. I was thinking about that as you were talking about how, you might have the surgeon who generates one and a half or $2 million of gross revenue annually, but if you talk to the technicians that work with him, who seem to have a turnover rate of 40%, maybe they would tell you that actually he’s a bit of a problem.
If we tolerate that person and tolerate that behavior – then that’s how we’ve defined our culture. His productivity usurps, the impact that he’s having on the people around him, that’s at the base of psychological safety. So psychological safety is a phenomenon that’s been heavily researched over the past 25 years, really driven by the work of Dr. Amy Edmondson. She’s the professor, a Novartis professor of leadership and management at Harvard business school. But it’s not just her. There’s been several other researchers who have done a lot of work on this. And we know pretty conclusively that the presence of psychological safety is a very strong predictor of a long-term performance of innovation, creativity, resilience, wellbeing, all sorts of the outcomes that we’re looking for in a work environment, and by the way, they can also be measured which is a really nice thing.
Essentially what we’re saying with psychological safety is that in this team environment, it is safe for you to be authentically you. It is safe for you to lean into the awkwardness and pain and discomfort of growth and learning because you’re going to stumble, you’re going to fall over and scrape your knees.
That’s the human part of growth and learning and achieving these big goals that we’re trying to achieve together. And it’s okay here. You can do that because when that happens, we’re all going to collectively learn from that and grow together. It’s okay in this environment to say, “Hey, you know what, actually, I have an idea for a way we can do things differently.” And people will listen to you and they will hear that it’s okay.
It’s safe in this environment to admit shortcomings, to talk to the people around you, even when it appears like everybody else knows how to do something and it seems like you’re the only one who doesn’t get it – that it’s actually safe for you to speak up and say: listen, I actually, I could use a little explaining here, I don’t really understand.
Some of it’s anecdotal, I’ll admit, but some of the research suggests that in our profession, probably somewhere between 60 to 75% of teams are just lacking in this.
And when we’ve created this sort of consistent, mild to moderate state of anxiety at work, because the impression that people have about us in our work environment is incredibly important to our sense of inclusion and belonging, but also to our ability to produce, to do the work that we’re trying to do.
And if we feel unsafe, we have to protect that impression. We start withholding things. We start with holding that we don’t know how to do things. We start trying to cover up the mistakes that we make. We start keeping to ourselves the ideas that might actually help that surgeon interact with his team a little bit better.
And then it comes out in these lagging indicators of productivity.
We have a question. Are there any practical steps to implement this positive psychology and psychological safety at the workplace?
Leaders have a wonderful opportunity to really bring this to life. Adam Grant conducted an experiment with Melinda Gates at the Gates Foundation. They were trying to actually elevate psychological safety throughout the organization because it can be measured. It’s like with bloodwork, you can measure it pre and post intervention. It’s a really nice way to conduct these kinds of business experiments in real time. One of the things that they found was that training leaders on the concept, empowering them with ways to elevate it does have an impact, but it tends to be short-lived unless there’s a sustained response to it or a sustained effort.
However, they did come up with a really fascinating intervention that I think speaks to the essence of this phenomenon. They had Melinda Gates, the head of the Gates Foundation, record a video about a mistake that she had made in her leadership of the organization and what she learned from it.
A psychologically safe environment is about creating a learning environment. It’s creating an environment where instead of being right, we’re focused on getting it right – together collectively. And so by her sitting in front of this camera and saying, “you know, listen, I am the head of this organization. I’m supposed to be the smartest, most talented, have all the answers, but actually I’ve screwed up and here’s how I’ve screwed up. And this is what I learned from it.” And then they disperse that video throughout the organization. I can’t remember the followup metric. It was either six weeks or six months, something like that, but they saw a sustained improvement in the overall sense of psychological safety throughout the entire organization.
So I think that as leaders, we have this wonderful opportunity to model the behaviors that we’re trying to drive in our culture and it trickles down. It does have an impact.
I just wanted to end with the practical steps from my standpoint about positivity and positive psychology. One, feel the abundance in your life by practicing daily gratitude. Two, focus on the things you can control and let go of the rest of that circle of influence, of that circle of concern. And three, find meaning and purpose. See and remember the difference you make. That you each on this call can significantly increase your happiness.
That’s amazing. With that, thank you guys. That was very empowering and interesting and insightful. So thank you for finding the time. You’re very busy people and hopefully our audience liked the webinar.