Jan. 5, 2024

#110: Practice Good Medicine - The Rest Will Take Care Of Itself. With Dr Gary Turnbull

#110: Practice Good Medicine - The Rest Will Take Care Of Itself. With Dr Gary Turnbull
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Season 1

This episode is available as a video podcast on Spotify.

Dr Gary Turnbull is a Director of The Lincoln Institute, a coach, speaker and facilitator in the fields of veterinary practice management and leadership, veterinary business models and life balance strategies. He’s also a former practice owner with decades of clinical vetting and leadership experience under his belt. Through his work at The Lincoln Institute, Gary helps practice owners and employees with "people problems”, team culture, staff engagement, productivity and profit. 

And it’s exactly the intersection between these things that I wanted to talk to Gary about: the seemingly opposing needs for  productivity and profit from a practice owner’s perspective with the desire of employed vets to have an engaged workplace with great culture. 

I love Gary’s role as a coach for both practice owners AND employed vets, because gives him some unique insights into topics like how team leaders can motivate productivity without the team feeling that it’s just more ways that the boss wants us to make them more money, how to productively give and receive feedback about productivity, why and how team leaders need to be crystal clear about their practice values, and for employed vets - how to approach that annual review and how to show value when you’re not the vet who bills the big surgeries. Gary also helps me with a guide to make those client money conversions a lot less anxiety-inducing, and I put his coaching skills around conflict situations to the test with the big question: how do you deal with that accusation of ‘all you care about is the money.’

 

Topic list:

11:25 The importance of leadership nuance and messaging.

19:48 How to set clear, supportive expectations for your team.

22:13 Always come back to standards of care over "purse protecting".

27:29 We need more data than an average transaction fee.

32:04 Keeping track of your bookings and reframing how we view our care recommendations.

40:04 Remembering that people prioritise their pet differently within their family unit.

47:33 The 6 steps that you should make a habit in the consult room.

59:13 Shifting the focus away from money.

63:27 Practice makes perfect (or makes us more comfortable).

70:11 How a client viewing what happens behind the scenes can change their perception of fees.

74:01 Gary's favourite podcasts.

74:28 Gary's one piece of advice for new grad vets.

 

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I'm recording this introduction on the 1st of January 2024.It's a very, very wet start to the new year where I live, so I have to time this in between rainstorms because my office and recording studio is in a tin shed.So even a little bit of rain sounds like a lot of rain.And it's been a lot of rain.
So if he hears some background noise, that's the sound of a QLD rainstorm on a tin roof.So it's New Year's Day.I personally don't really do New Year's resolutions.It feels like a fairly arbitrary thing to base the timing of your commitments and your goals on the movement of our planet around the sun.
That, and as I'm sure you've learned for yourself, New Year's resolutions well.If they really worked.I'd be a millionaire with a six pack and three impeccably behaved kids.No, actually, just two kids.Saying that, from this day onwards I will forevermore start doing this or stop doing this and make rules about it.
I don't know about you, but it generally just doesn't work for me.So rather than picking one day to change everything, I try to remember that every day, every moment is an opportunity to commit and to recommit to your values and your goals rather than waiting for the fireworks to start.
Having said that, it is impossible to get to the 1st of January without a feeling of some degree of significance, right?Most of the world takes a moment to pause and to reset before the next round starts, so it's inevitable that we will have some.Sort of a review.Of how our year went, maybe beat ourselves up a little bit for how we failed to be the person that we wanted to be and to hope that this year, this year, I'll be better.
So while I don't make flimsy promises to myself, like when I exercise more, I'm going to start meditating every single day.Or from this day onwards, I'll stop eating all the biscuits at work because who am I kidding, I do take stock in much broader terms to use that inevitable pensiveness that accompanies the new Year, and also to leverage that sense of optimism and a fresh beginning to review and if needs be, reset the general direction that I'm moving in.
I picture it in my head as deciding where I want to head towards, then taking an anchor and hurling it with all of my might towards that place and then slowly pulling myself towards that place with the anchor.That way when I inevitably get distracted.
Blown of course, by all of the stuff that life throws at you, or when I lose discipline and mess up, it's really not a failure.You can always get up, reorientate and start moving back towards that aim.So that's New Year's for me, checking to see if my anchor or my anchors are still in the right place and then repositioning them if they are not.
But I want to share something that I came across this week that provides a bit of a structure to this process.It's from the podcast of Mel Robbins.She explains that she does a similar annual review, but she uses a framework of six questions that she asked herself at the end of each year to help her pick her priorities for the year.
I'm not gonna recap her whole podcast here, but the six questions in brief are #1 What are the highlights of my hair?#2 what were the hardest aspects of my hair, #3 what did I learn about myself?And then once she's done that review of the year, she then uses the following three questions to decide how she's going to move forward with the next year.
So the 4th question is what other things I want to stop doing #5, what other things do I want to start doing?And number six, what other things that I want to continue doing?So basically, what was good about my hair?What sucked?
What did I learn about myself?What I want to do less of, What do I want to do more of?And what worked.Now, again, I'm not gonna review the whole entire process.Mel digs a lot into the details of how she decides what those highlights and the challenges were.And then she also divides those six questions into different categories like personal life and work life, money, finances, spirituality, things like that.
But I wanted to underline 2 things that stood out for me.First off, the question of what do I want less of?The temptation for most of us is to think about what do I need more of this year, what I need to add to my life to be better.But I love that.One of the questions is what should I take away?
What were the things that added to the suck or took up space that could be filled with good stuff?So I'll share a couple of things that I've come up with for myself that I want less of.I want less anger, anger at my kids, at work, frustrations at myself.
I want less screen time.I want less procrastination.I want to do less cleaning.In fact, I'm pretty sure that the lack of cleaning on the part of my kids contributes significantly to that anger, that I want less of it.I'm not sure how exactly I'm going to achieve.Teaching my kids how to clean up after themselves would help.
Maybe I need to find a way to be able to get a cleaner in once or twice a week, but by throwing my anger out towards these, I determine the direction I want to move in.I can work out the how as I go.The second thing I want to underline is question one and question six.What were the highlights and what am I doing that's working and I should keep doing?
I love that it's the 1st and the last question because it means that you start and end the process with a question that can only inspire gratitude, which we all know is a major player in creating Wellness, which is definitely one of the things that I want more of in 2024.So what about you?
What are your anchors going to be for 2024?OK, let's get to our episode.I can't think of a better way to help us decide where to throw our work anchors for 2024 then with a conversation with Doctor Gary Turnbull.I caught up with Gary at last year's Vets On Tour conference in Wanaka, New Zealand, where he was one of the guest speakers.
I was loving Gary Sessions, but of course I had many more questions for him, so I offered him a lift one day up the mountain for the daily ski sessions.That happened at Vets on tour between the morning and the evening lectures.But then, as soon as I had him secured in a confined space, I put my new portable microphone on him and started recording a podcast.
The result is kind of like Carpool Karaoke, but without the celebrities and without the singing.But who knows, maybe we'll work on the singing next time.I even stuck my phone on the dashboard to film us.So if you want to watch this interview instead of just listening, it is available as a video podcast on Spotify and we will Chuck it onto our YouTube channel as well.
By the way, I've made sure that my name is back on the guest list for Wannaca 2024.It's definitely one of the answers for the things I want more of in 2024.It's booked for the 11th to the 16th of August, so block it off on your calendar and we'll get you in the vet felt carpool karaoke recording as we head up the mountain for a ski session.
Doctor Gary Turnbull is a director at the Lincoln Institute, a coach, speaker and facilitator in the fields of veterinary practice management and leadership, veterinary business models and life balance strategies.He's also a former practice owner with decades of clinical vetting and leadership experience under his spell.
Through his work at the Lincoln Institute, Gary helps practice owners and employees with people problems, team culture, staff engagement, productivity, and profit.And it's exactly the intersection between these things that I wanted to talk to Gary about the seemingly opposing needs for productivity and profit from a practice owner's perspective, with the desire of employed vets to have an engaged workplace with a great culture.
I love Gary's role as a coach for both practice owners and employed vets because it gives them some unique insights into topics like how team leaders can motivate productivity without the team feeling that it's just another way that the boss wants the team to make more money for them.How to give and receive feedback about productivity, Why, and how team leaders need to be crystal clear about their practice values.
And for the employed vets, how to approach that annual review and how to show value when you are not the vet who builds those big surgeries.Gary also helps me with a guide to make those client money conversations a lot less anxiety inducing.And I put his coaching skills around conflict situations to the test.
With the big question, how do you deal with that accusation that all you care about is the money?You'll find Gary and his work at lincolninstitute.com dot AU and I'll put a link in the show description to Lincoln's Veterinary Sustainability Pilot Study which showed very strong evidence that improving your non clinical skills can make a huge difference to your levels of job satisfaction and fulfillment.
It makes for some really interesting reading.OK, let's get into it.Oh, and Happy New Year, Doctor Gary.Turnbull, welcome to the Red Vault podcast.
A very different version, yeah, of the Red Vault podcast.Where are we, Gary?Well, we're currently on our way from Monica to Cadrona.Ski fields take on the slopes.New Zealand at the vets at tour conference, Gary speaking at the conference and I thought it was an opportune moment to get him in a confined space.
He can't go anywhere.There was no escape.I don't know.It's great.It's great to be here.So many firsts for the red belt A we don't do video normally.Second, I normally have notes that might not sound that prepared, but I'm usually prepared and I have notes guide the conversation.
So this might be less of an interview in in more of a ramble, but I'm excited.I'm really excited to chat to you.So quick background, I said we don't do BIOS, but you coach for the Lincoln Institute, coach practices also coach.You do programs for employed vets, right?
It's not just practice owners.So, which actually gives you a unique insight because the two can sometimes clash a little bit, yeah.Sure.And but then you were also until when a practice owner of a of a very successful vet practice, right?Yeah.Yeah.
So I guess super quick historically practice owner for years from 2000 to 2020 with my my wife.And it was a long that journey that I recognized that I was a really I think I was a good technician, I was a good clinician and so many veterinarians ended up in practice ownership and realized along the way that there was a whole skill set that I simply didn't have, how to lead a team of people, how to develop and execute on sound business strategy.
All of that was completely foreign to me.And I just figured for some reason it would just work out for the best.And we did OK.But there was so much area where we could improve the experience for our team, where we could be more successful, more prosperous commercially, which meant freedom to reinvest in our people, at our practice.
And I'd enjoy a better sort of balance in life as well, having been mentored by the the founder of Lincoln Institute, Paul Ainsworth, who's got amazing expertise in both personal and executive leadership through his experience in the Australian infantry and his work in the corporate sector in Australia.
Having completed an MBA, that really just profoundly changed my experience as a practice owner and as a veterinarian and as a person, to be honest, and I felt compelled to share that with like minded colleagues.Hence Lincoln's direction into the veterinary profession specifically.
OK, now usually the other difference in this conversation is I normally prep people for some of the questions.I normally kick off with a statement that I saw on a graffiti on the side of a building that said bad decisions lead to good stories.So I asked my guests, they agree and you can disagree.
You can say I've had people say no, no, it's a very traumatic replication from bad decisions.Oh, if you do agree, do you have an example of a story of of that fits with that?Yeah, OK, so bad, bad decisions lead to good stories.Good stories, like, certainly lead to good stories.
I guess my immediate response to that without having time to think about it too much, is it depends on mindset.For me is my immediate reaction, because what's a bad decision anyway?It's almost like that line of thinking of failure is only a failure if you call it a failure.
A bad decision is probably only a bad decision if there's not some learnings from it and gross either personally and or professionally as an organization.In terms of an example, I will need to think for a minute.I'm sure there's plenty of bad decisions along the way, but just trying to think of one specifically you can.
Come back to yeah.Yeah, OK.Come back to that, I'll edit it back in, OK. 1st.Thing I want to start with, and I think you're probably the perfect person to talk to this because of your role in Lincoln.You've been an owner a lot of this stuff, and I agree that it's really vital stuff.
I've been an owner as well and I've worked for some.I was going to say bad bosses, not bad people.Just.People who don't have the skills or the the stuff they should learn, but they don't make the time for it.But on the flip side, the perception from employed vets, and I know this from speaking to vets, and sometimes they don't.
Let's say I'm a practice owner and I decide I'm going to go with Lincoln and we're going to start teaching these skills.We talked last night.Your talk was about getting owners to yes, and there's a lot of stuff that can sometimes feel, feel to a vet.Oh, the boss is teaching me how to make him more money.
I'm doing all the work.I'm not really interested in this shit.I just want to do my vet work and it adds stress to my life because the stuff you're asking me to do increases conflict sometimes, which we'll come back to.I want to ask you about conflict.So I don't want to engage with this stuff.
And then to some degree when you guys do teach practices how to be more commercially successful, so it does come down to money to some degree as well.How do you integrate the two?How do you get the buy in from the team without coming across as hey guys make more sales.
Yeah, because make me more money and then and then like the vets can also sometimes if it is a successful practice owner, I don't know.Do you ever find that there's resentment to go.The bus goes on for overseas holidays a beer and he has a holiday house in Byron Bay and I'm on 40 bucks an hour.Yeah, yeah.Yeah, yeah.
Now look, I think the this comes down to leadership nuance and the messaging and and really the purpose behind we're doing whatever we're going to do because nothing will demotivate a veterinarian more than a conversation like we've looked at some numbers and Benchmark tell us that you should be doing 2.2 more radiographs per week.
And that's what happens, right?Yeah.Yeah, this happens, yeah.Yeah, which is a really bad conversation because it's it's poorly delivered feedback with all the wrong motivation behind it.What on earth does 2.2 more X-rays per week mean?And so the nuance is shifting the focus and this is authentic.
This is not contrived in any way.Shifting it back to our purpose.And this is where fundamentally a lot of practices have a gap in the 1st place is why do we do what we do?Why do we as a team turn up every day to take on and tackle what we do and that profession.
It's pretty clear what we do.We we keep well animals well through preventative healthcare and we treat sick and injured to restore them to health.So that the what we do is pretty straightforward.The how we do it, that's your unique selling proposition.What what makes you different from the practice down the road where often where it gets overlooked by organizations or veterinary practices is why do we do this And that's important at a personal level as well.
Why do we turn up to work every day and and do what we do.And that's going to be very very personal and and different for each individual and that's where it starts is why do we do this And from a from a integrating the commercial with the the purpose motives if we can tap into our sense of purpose and for most a strong element of that is going to be patient advocacy.
It's some version of I'm the voice for those who can't speak for themselves and for some it will be that combined with I'm here to help people I I make a contribution of the world by helping people.The currency through which I help them is, is their pets or in a in a mixed setting it's it's that kind of business to business relationship and I'm make an investment in a in May and I'll return provide a return on that investment in your business and your business success.
And this is something that's that's well recognized good medicine or practice good medicine and the commercial component will take care of take care of itself.Yeah the messaging is really got to be aligned with WhatsApp purpose as an organization.
Let's talk about your purpose personally and aligning with that.Being a patient advocate, making a difference, making a positive contribution for pets and their families or or in the the primary produced setting for businesses is ultimately going to lead indirectly to great commercial results.
So for the employed with actually no.Let's ask this question because you mentioned the the conversation about you should do your your average invoice is too low.Does that conversation sometimes have to be had in some extent because you're going to look at KPIs, you're going to look at measures.
I understand as a business owner, if there is a A-Team member that stands out that goes everybody's here and you're down here, we have to look at at the why.So sometimes does that conversation have to be had always?
I think that the starting point is one of the reasons why we have to have those.The difficult conversations is because expectations aren't set clearly enough in the 1st place.OK, so often your reasons for under performance as it were, is because there's ambiguity around either at practice values and or the standards of care that we recognize and look to adopt within our practice.
And so you can have a situation where every clinician is running their own race a little bit rather than a more collaborative approach where we all agree this is how we do it here.And that will be closely linked to, as I said, standards of care and the values and the vision of the practice as well.
And when that's missing, vague goals lead to vague results.So if I don't know what you're expecting of me, chances are I'm not going to meet your expectations.People, people don't turn up to work to let you down on purpose and they don't.
It's an act of defiance.It's usually because those expectations aren't set clearly enough in the 1st place and it's easy to make it assumptions because as a as a business owner, I I view it this way or I view the world this way, we're all, we're all guilty of that, that egocentric bias.
I tend to think everybody thinks the way I do.So the first step is, is ensuring that we've got really clear expectations, so.What what does it look like?Does it start at the at the interview, the start of the interview where you say, look, we're looking for a vet, here's how we do it.We are a high level practice where we do the work UPS or say look, we're in a in a socio, economically poorer area and be clear about how we practice and what we expect.
And if that doesn't fit with you, I don't know.Don't know that you, like, work for us, yeah.Yeah.Look, I think it's important to to position the practice and what your philosophy or approach is, what the the, the, the vision or the sense of purpose is.
And I guess we'd also be hoping at that interview stage that there's going to be some good questions around that as well.We're going to be careful in recruitment in terms of leading people.It'd be really easy to start.He's at practice values.What do you think?Well, that's a pretty one he's going to answer.
Yeah, I love it.I agree.I agree with all of that.So it's flipping that around.So tell me what are the things in life that you value most and looking to explore their values and and looking for alignment with that and then hoping in reverse when we are the the person we're interviewing any questions for us that that that's going to be really instructive as well as or insightful as to what questions, what's important to them?
OK, so they, we do know, though, that people tell you what they think you want to hear in an interview.Yeah.So it's not a foolproof way.So let's say I'm employed a vet or I'm an employer and I've never had this conversation.And now I want to start getting better at this thing.And so at some point, I do have to have a conversation to say, look, it's three months into your employment, you're not delivering financially.
But again, it's we said before, it's not about the finances.How do you frame that?How do you approach that conversation in a way that doesn't sound like you're not making me enough money?Yeah, yeah.Because people react to that in a very bad way.I can tell you that from the social media page, Yeah.Yeah, no, absolutely and quite rightly they should.
The the the conversation is really more about, in the first instance, gathering information, entering this with curiosity, understanding what's going on for them and having some data around.
That can be really helpful as well because there's probably two key aspects of what's going on in the conversations in the consultation room.One is what's my propensity to make a best recommendation, whatever best looks like within your practice.
Again, coming back to standards of care and and values because it's not uncommon as we were talking about last night, it's not uncommon for veterinarians to slip into this mindset off wallet guardian or purse protector.
So I'm going to make some assumptions here about what the client wants and I will make some compromises in my recommendations because that will save them some money and and that's a good thing as opposed to making the recommendations that align with expectations, the standards of care and letting the client decide.
So.Number one is what's going on there from a a self worth and mindset perspective and what are those conversations being had or not being had.And secondly is the ability to possibly influence a client to yes with with your ethical recommendations, because that's another area we know from our own research that veterinarians will really dislike financially related conversations and so, but there's often a lot of ambiguity in those conversations, a lot of the use of inferential language, what we ideally do in these situations, what we could do in this situation.
Inferential meaning try to infer, yeah, try to infer that you should do a dental.Yeah, right.Well, but I'm not telling you, look, we should do a dental.That's a lot of pain, Yeah.So a a simple example would be to say to somebody I'm thirsty rather than asking can I have a drink.
It's it's it's rowing information out there.Can you talk to my wife?And and hoping that the recipient will pick up on that.And clients need to be led to an extent.You know what there is in that room.
There is a laypersonal laypeople who know very little if anything and there is a relative expert in the room.And as that expert we have I think a responsibility to support the decision making process with our expertise.
And and for a lot of veterinarians because they get caught up in the issue of money which is which is really for the client to decide and determine not them, is to, is to struggle with focusing on being the patient advocate and making the best recommendations in the patient's interests.
We're being mindful of course of of the client as well, but doing that in a collaborative fashion, so bringing the client in and not cutting corners or compromising based on what they think the client might want.So, so having some data around those two aspects is really helpful because it helps us to target the conversation.
This is a very different conversation between someone who is electing for, say, a therapeutic trial over diagnostics, thinking that that's the best way to go because they're saving the client money versus a conversation where a veterinarian is making recommendation after recommendation and clients are declining time and again because the message is getting lost in inferential language or because we've delivered a multitude of options and now the client is confused.
There's a whole a whole range of factors there that can lead a client more to a not yet as opposed to a hard no.Let's put that into practice.I'm, I'm your employer.I look at the at the numbers and there is 40% below everybody else on the average invoice.
How do I do this with you?I come to you I say, hey Gary look I'd love to chat to you about these invoice things.I here's the here's the data.Here are the facts.I'm not that interested in the finances specific, but I want to understand why that is because I just want to make sure that you're not getting stuck on giving the clients to take your recommendation or I want to make sure that you are recommending the correct treatment and not having some sort of.
Is that the sort of conversation that?You have the conversation would have nothing to do with money or finances at all, so the.Money financing.That's a it's a symptom, basically, Yeah.You see it as a as an early warning sign symptom.Yeah, Let's look at the It's a cause, yeah.
It's a measure to to help us simply understand what's going on.OK, one of the keys to feedback successfully delivering feedback is it needs to be specific and it needs to be accurate.And so it's it's not going to land if we're talking in board brush strokes.
I've got a general sense of this.Or I get the feeling that that quite rightly the recipient should start with.Can you give me an example?The.The the metrics is is simply the data that moves us from opinion to fact because.
We don't want to be.Talking an opinion we we need to be, we need to be delivering accurate, specific information that's based on fact.Quick little detour.Yeah.Yeah, that's OK.I think a lot of it's are open to getting that feedback because we do.Also we want to know that we do a good job, right?
Yeah, it's almost worse to have no feedback thing.I don't even know if the boss liked me or they just put up with me because they can't fight anybody.Yeah, yeah.One thing that I see often, and I I think this was a thing for me as well, is when the measure of this thing is the the average invoice.
That's the sole measure.It.Can be misleading depending on how your role in the practice.I think I'm a pretty decent consulting vet and medicine person from not an orthopedic surgeon.I could be the number one vet for booking in Christian surgeries very quickly.
For the surgeon, yes.I'm not doing the surgery.I'm not billing the surgery, the surgeon's invoices, his average invoice is twice mine and the boss thinks he's amazing.Yeah.How do you coach owners or or vets on that?How do you to approach?That certainly from a practice leader perspective, we really need more data than an average transaction fee for exactly the reason that you highlight there.
And one of the limitations of a lot of practice management softwares is that yeah, you can plug in a report and it'll give you each veterinarian's name and it'll give you the total income generated and it'll give you an average transaction fee.But it doesn't dig down to that Next level, as I mention, is, well, how often are we making recommendations and how often are we converting those recommendations?
Because they're just two very, very different conversations.I might be excellent at booking my reject, but then I it's a reduced consult fee so it pulls my average down.That's.Exactly right.Yeah.Yeah.Now that's exactly right.So we need more data to be working with OK than simply an average transaction fee and also recognizing that the value that the clinician brings to the table is not just based on dollars and cents.
There are there are the factors you like you quite rightly point out you can have a rainmaker who had who is incredibly sophisticated in the console room and and and get the clients to a yes, but doesn't actually do the technical work.So it can look quite misleading.
Yeah, we might all there are, there are other aspects in in terms of coaching and mentoring other team members.The contribution they make to continuing development, we might delegate other activities to them that that contributes to the overall success and outcome of the practice.
So we've got to look beyond KPI.It doesn't mean we we ignore them, but we've got to look at enough data to have a meaningful conversation and we've got to also place appropriate weighting on on that as well in terms of the overall product or or or outcome that we're looking from the veterinarian themselves.
So as an.Owner what do you look at?How?How do you because of that, Some of those things are actually quite hard to measure, especially if you're not on the floor.It's all right if you're if you're there five days a week and you see how much clients love this vet.But if you're not, let's say I've got 3 branch practices and I've.I don't ever spend time with vet X and all the numbers.
She's not a great vet, great employee.She might be a great vet.Yeah.How do you measure that?That's.Where there needs to be in the instance where we're not at the coalface all day, every day or at least frequently, there's got to be some leadership pipeline.We're going to have somebody with a with some level of responsibility and leadership who can help provide insight on this because we we need that feedback on on how everybody's performing.
So there's got to be a level of leadership within any site.And this is often where we find a shortcoming for veterinary practices is that there is actually there's no on site leadership and the team making the rules up themselves.
Because if you don't set clear expectations, set the rules, they'll make them up and or the wrong person is appointed into a position of leadership and responsibility.And that's because they're the one who's been working there the longest or they're the oldest, although they're technically the most capable, doesn't mean they've got any of the attributes or talents that are required for leadership.
Or finally we might select a white person but then fail to upskill them, OK, because it's a completely different responsibility and value set to their role in the in the technical capacity.So we've got to have that pipeline of the right people that are radically upskilled we're.Going to have to pause because we're going to have to key we'll do Part 2.
But I do want to say because many people might be in a practice employed in a practice that doesn't have the right there's very few practices who has very terrific.So in that scenario, I have mentored some of my my mentees to say and tell them because it because it comes into play when you start looking at selling negotiations, they want to get a pay increase.
But they know they're going to get their numbers that are in front of them as a defence almost.And I've meant to them to say well keep track of it, have a little notebook, this, how booked, booked this and this so that when you go into some of the I've booked, I haven't done, but I've booked $300,000 worth of surgery.
Yeah, Yeah.Does that make sense?Absolutely.I think.Anything we measure, as soon as you start to measure, it'll start to improve.And it was very true what you said before.We used to talk KPIs with our veterinarians as part of the conversation.Again, not with the the profit motive in mind, but but tying it back to sense of purpose.
If if it's got to be incredibly frustrating, if you're making recommendations and clients are not taking on that recommendation, it's got to be frustrating and disappointing because you're not getting to do the work that you're trying to do and that you're passionate about.Your patient is not getting the best care and you won't have ultimately the happiest client.
So tell me what's going on, what a client saying no to Let's see if we can address this and talk about ways by which we can improve that experience for you because we get a win, win, win.You're doing the work that you were trying to do and passionate about.You're achieving better patient outcomes.You've got a happier client and the practice is is more financially prosperous, which means we can recognize you well financially, We can pay you well, we can invest in your development, we can invest in facilities and equipment.
So it all stems from that purpose and and what's going on for you and it's it's a different conversation if it's a we're not making recommendations the 1st place tell me about that what what's going on for you why are in these instances why are we defaulting to a therapeutic trial as opposed to diagnostics as an example and and and exploring that and understanding and often it's just the the language veterinarians can get trapped in this mindset of oh I didn't find anything abnormal on the X-rays so I've just wasted their money and and sitting the client's expectations oh now I've got to tell them the X-rays were normal.
Let's flip that around and start with look I hope that I find nothing serious on these X-rays.Hopefully they'll come back.Oh, it's going to be some soft tissue swelling and nothing else.That's my hope.But the only way that we can have Peace of Mind is to do the diagnostics and say what we find.
If I do find anything abnormal, if it's clinically really significant, I'll ring you straight away so we can talk about what we're going to do about that.Yeah, But hopefully it's going to be all clear.And then you and I both have the Peace of Mind that we're not missing anything.Yeah.I'm not vigorously because I had to say that was me.
I still struggle with it.I I, I have that wallet.We'll talk about money in Part 2.Yeah.And many issues, personal money issues.But I I I definitely had, I'd still have a bit of a wallet.I don't want to waste.People like exactly that.I don't like waste in general so I used to be really bad at saying I think we can get away without X-rays or whatever thing but it's exactly that a it's understanding more.
The more I learn clinically the more I grow.I have a better understanding now of OK This is why we should really do it and then reframing it to the client.That big reframe was was massive for me to go look, I I don't think there's a big issue, but it probably is this.But it is my job to make sure there's nothing more and to to warn you about the other things.
So X-ray would be great to rule out this this and this and this because if it is that, it's a way different story.So if it's OK with you, if it's doable, yeah.Let's do the X-rays.Then we can all relax about it.Yeah.If you can't, no drivers we can't.I'm quite happy to treat because as I said at the beginning, it's probably nothing.
Yeah.But if I miss it, it's gonna be a big deal.Yeah.Exactly.And that's the difference between not giving the client the choice to make that decision in the 1st place.Yeah.Based on assumption, I'll save them some money here for most clients look and there are of course there are clients that where where cost is the primary concern.
I'm one of those clients.And.And no, no judgement there at all.And not at all.However, let's let the client make that decision.Let's focus on being the best patient advocate, because the vast majority of clients do want Peace of Mind.
They do want surety.They do want to know.They want to be.They want validation.They want to know that they're good.That's why they're.There.Exactly.That's exactly right.They're there for a reason, and it's.Changed.For me, It's interesting.I find it much easier since starting to work in emergency because I the realization that it's midnight.
This person's here for something that I think's nothing.But they're clearly very worried to get there at midnight and pay a double cancel fee.They want to know.Absolutely.So then I go, it's really a disservice to go, hey, probably probably nothing to worry about.Yeah.And the minute we start to compromise, we increase the risk of misdiagnosis.
We increase the risk of unnecessary patient suffering.We suffer an increased level of dissatisfaction because we're not really doing the best that we were were trying to do.We're not getting to exercise that expertise that we've spent so long to develop.
The the risk of complaint escalates.It's very rare that a client would complain at any level because too much was done, as long as we set clear expectations around costs.So if they understand that, it's almost invariably because the veterinarian didn't do enough, yeah.
And I went different.We've got to go skiing, so we've got to wrap it up.But differentiate complaints in a whinge.They'll whinge about the money, of course.Yeah.Genuine complaints will.Do.Yeah, exactly.Yeah, yeah.Yeah.Yeah, but a genuine complaint that's going to come from under servicing.Yeah, from.This or something, remember?Nobody wants to spend the money.
Oh, no.They know.They know they need to, but nobody wants to do that.So it's it is important to to to recognize that.Oh, that's expensive.That's very expensive.Yeah, it is.It is very.It really is.And and unfortunately medicine is.Yeah.Yeah, OK.That's by two.By two will be my my personal counselling on my own money.
Sounds good.While Gary and I hit up the mountain for a ski, I thought I would take a second to remind you about our specialist support space.We've created a space where you can chat to a specialist about those frustrating cases where you can't refer or It's not quite a referral case, but you just need a little bit of extra brain power or experience to help you get over that hump.
You can upload files and images like X-rays or videos, or you can even jump on a live chat if the case requires it.I'm actually quite enjoying using the space to help me impact cases after the fact where things didn't necessarily go according to plan.It is a paid space so that our specialists get compensated for their time, which has the added benefit that you no longer have to feel guilty about asking for free advice.
But we've tried to keep it widely accessible by pricing it at around $15.00 a month, which lets you ask as many questions as you want.For now, we have a specialist in small animal medicine, emergency and critical care, as well as dermatology.Check out the details and the T's and C's by clicking on the link for this space in the episode show description and go give it a try.
OK, let's get back to Gary.We're.Back Part 2 Here we go Post ski chat.How did you go with the slopes?Yeah.Look, I was pretty happy.I had no stacks off the the chair lift.That's a big improvement for me, so I'm happy with the day having.
Broken, tired, happy.Yeah.No, no, no injuries.So to win so.I can't quite remember where we left off but I think we should talk about the money conversation.Yeah it is still a hard conversation for four vets to have.I know you did the social styles yesterday and the amiibles us conflict avoiding people pleasing and we want to do the work right we want to fix the animals and then we've got to say and it's going to cost and still 20 ideas in that that's biggest for me.
I still when it comes to and I've complete.Confidence in what I want to do.And I don't believe that it's overcharging, but then I have to go out there.I do my estimate that I have to go out there and say, yeah, this life saving surgery we need to do, it's going to be mixed out.
Yeah, yeah.And I.Find it?Really.Hard.Yeah, not a line.I know there's not too many veterinarians that don't find that a real challenge.I I I think I had a thought last night when you were talking.You think it's maybe because you talk about what is expensive.It's a very relative term.
What is a lot of money?That depends on who you are.But do you think maybe a part of it is is also because we're not a massive earning profession.So just tell somebody that you're going to be 56000 out of pocket for something would hurt me a lot personally because it's a lot of money.
If I had to go to mechanic and they said yeah, you're you Gearbox is going to be 5000.Like, I wouldn't be angry at him, but I'd be very sad.And then add to that how hopefully we can talk about empathy as well.I can.I see a family come in with young kids and I know I've got to tell them you're going to be 5000 out of pocket.
It's a it's a stress.And I feel for them before I even say it.Maybe they feel less about it than I do, but I feel for it.I.I certainly wonder about that and I think what can happen is and it's not that it's not important for us to be taking all of this into consideration.
But at the end of the day, our expertise is around veterinary medicine and it's our clinical expertise that the general public are coming to us for.And I think we can just get a little lost or off track in terms of that that primary or intrinsic sense of purpose shifting away from being the patient advocate and just moving more towards we use that term the wallet guardian or the the purse protector which where where that sense of purpose starts to refocus or migrate towards honey.
And at the end of the day that's that's the client's responsibility, that's the client's the family's decision.And it's not just about money either, it's very much about personal values and priorities.There are, you see, the two ends of the spectrum, Clients that are clearly not challenged financially and yet don't place a high value on their pets, so unwilling to spend a lot of money.
And then there are others who will forgo themselves in order to pursue the best treatment option based on their veterinarian's recommendation.Whatever the cost they'll they'll make it work.It's it's not just about money.
It's it's people's personal value set and how they prioritize their pet within their family unit.Interestingly, I was meeting with Steven Feldman, the president and founder of the Human Animal Bond Research Institute just recently and he was saying in their research 84% of pet owners consider their pet to be a member of the family if it was one of our children.
We don't ignore the cost of treatment, but but it's put into perspective with the outcome we're looking to achieve, which is to repair, fix, heal, maintain, yeah.
See, I get all of this rationally, my rational brain 100%.Have you heard about the concept?I think I've spoken about it before on the podcast.Somebody else told me about it.The concept of your brain.The elephant rider?No, I had not heard of.
It No.So there's.A psychologist who who explained the difference between your emotional brain to the limbic system and your rational brain, which we're all aware of.But when I used to think about that, I always felt like we have the rationals in charge.
It is the underlying maybe it's 8020 or at least 5050, but this psychologist wrote about it.It says no.It is like a person riding a trained elephant.The elephant is the emotional part.The rider is in charge when things are going well.But if things are not going well if the elephant gets upset then you've got no charge yeah no hope.
You hold on and you're hope for the best and you're hopefully this fish comes down to which which when you talk about for me the money thing the elephant takes I sit there like got to go talk to them forgot to say and and I've I wonder.I've often wondered about why.What is it that I find so?
So.Uncomfortable.Yeah, yeah.And look, yeah there is some work around a sense of self worth amongst veterinarians and that we and this is of course generalizing that as a a community or a profession we struggle to value ourselves well.
Think that strong empath component drives us to want to deliver results irrespective of money.The number of veterinarians that I've spoken to that say I would just do it all for free if I possibly could, yeah, because.You just want to get the work done.
That's what we're there to do.And money is AI understand it's a lubricant, but it can feel like stomach block, yeah?Yeah.And we talk about the, it is an exchange.What we're delivering is years and years and years of education and dedication and development to develop that clinical mastery to provide the clinical care that we do and of course the exchange for that is money and and that's that fundamental of reciprocity.
One thing I would say and I of course mentioned this last night is that I often talk about the, the three voices in the room, the one that the voice that of reason that our client can hear that he's listening and and providing information to the client based on clinical findings and differential diagnosis and treatment plans or ways forward and so forth.
Obviously the client's voice which they're they're sharing their perspective historically and and providing feedback to what we're saying.And then I I I truly believe it and certainly it was true for me in 20 years of practice.There is just that niggling little voice that might be conscious, might be subconscious but it's making comments like or asking questions like what if they say no, what if they say yes, but they actually can't afford it.
Yep.What if they think I'm over servicing or being pushing?What if they don't like me?What if they go somewhere else?There's all these questions going on in the background and I think that's where that emotional brain can start to kick in and we start to waver.
And of course we're very good at picking up on non verbal cues.Yeah, tone of voice, facial expression, body language.So if we're uncomfortable, if we're demonstrating discomfort at the point of money, the client is going to pick up on that almost guaranteed and they're going to be thinking what's going on here.
One of the solutions that that we've implemented with veterinarians through education and and has certainly produced profound results based on objective and subjective measurement is to provide a if you want to go to term a system, a six step, six step system within the consultation room.
And that allows the vendor to create somewhat of a habit and in habits like that allows us to switch off when when we're in a habit we're in autopilot.So we're trying to create a habit in the consult room which creates a sense of disconnect from that voice or it silences the voice.
Because I just now, now I'm up to Step 3.So now I'll do step three.Now I'll move on to Step 4.Now it's Step 5.And by following a sequence, the more one practices that, the more it becomes habitual, and certainly the more it silences that that niggling voice that creates the questions, So what?
Are the six steps.What do you have to pay for this?No, look, I'm it starts with just preparing ourselves and that might only take 30 seconds to a minute, particularly this transitioning from the last consult to the next consult and and in some experiences it might be moving from a euthanasia to a puppy vaccination or vice versa.
It can just simply be going from a challenging diagnostic case to the next.And so just taking a minute or so to prepare and and recalibrate, reflecting on the last experience and how to through an optimistic lens, How did I improve, what did I do, followed by just resetting, getting present again and then committing to the outcome we're looking for.
And that is to deliver the very best ethical recommendations based on your knowledge, the standards of care that are adopted within your practice, your practice values and so forth and ensuring to the best of your ability you create a a positive experience for your patient minimizing fear and anxiety for them and a positive experience for your client.
And and largely there is to ensure that they leave the practice without being confused.And I think that's one of the the most overlooked challenges that we face is that we're operating in a world that is completely foreign to our clients.
And particularly when we start delivering lots of options, it can become quite confusing.And in the face of confusion and overwhelm, a client will defer decision making and you'll hear something like OK, we'll have a think about that and we'll, we'll, we'll let you know.So just a first step is just a little mental, emotional and physical reset to bring your best self into that interaction.
The the second step is building rapport.It's easy sometimes because we have loyal clients who've known us for years and and that rapport is is already there.But what we recognize is that for people to buy from us and of course whether we like it or not in that consult room, we are in sales, non sales selling, we're selling a diagnosis or a diagnostic plan, we're selling a treatment plan, we're selling a procedure.
And therefore for people to buy from us, they need to trust us and they need to like us.Trust and likability are fundamental.So we're going to spend a short period of time just building rapport with our clients and there's a multitude of ways through which we can do that.
We talk a lot about both verbal and non verbal cues and energy levels and so forth.So a short period of time just in that rapport building phase that comes more naturally to some people, those who are more people oriented, more task oriented, though that's going to require a little bit more conscious effort.
It won't be quite such a natural, reflexive action.Then the third step is to what we would term create the need and that's essentially collecting history, performing examination and identifying the problem list as it were if it's a primitive health care examination and say vaccination, when we don't have a problem list as such, it's more about it.
Everything checks out, OK, we'll make sure that all that preventatives are up to date, no questions nutritionally.And we'll now administer the, the prophylactic medication that the the visit's based on.But in many instances of course that will be that the patient was presented with a concern or health problem and we will be exploring that and along the way we might may find other unidentified concerns as well.
And that's particularly where that little voice about what if they think I'm over servicing or being pushy comes to the fore when as a veterinarian I've got to have a conversation with my client about something that they don't know about and bringing something into their sort of conscious awareness and that can make veterinarians very uncomfortable.
So we we create the need and then we move to warming that.And by warming the need, we're talking about presenting things in a way that's going to resonate for the client who is buying.And by that I mean we're positively influencing our clients to a yes with their best ethical recommendations.
So that's kind of work for them.And so I as I mentioned last night with the group that we were working with as scientists and and being high detail and and evidence based, we often revert to the features.
So let me talk to you about all the things that we're going to do and that's not necessarily speaking to the part of the brain that does the decision making or the the buying decision.It's much more those emotional centres that are that are driving that.So I'm not saying that we don't have to discuss those sort of features, what's involved in fact that's a critical part.
But let's start with the benefits.So we talk about and bring some emotion into it.So it's going to resonate with the decision making parts of the brain for our client.And one of the most powerful things and what clients want is Peace of Mind.All they want surety.
And so when we make a recommendation, coupling that with the the recognition that this is how I can provide Peace of Mind for you and for me as the clinician, this is the only way we can know all these steps are what's going to allow us to know what's actually going on here.
So that would be #1, #2 is validation.It's just like parents, every parent wants to know that they're good parents.Equally pet owners want to know that they're a good pet parent.So validation, this is the best that we can do here.
If you're here to to learn and and follow through on what's the very best for your pet, here's what it is.And then just their their connection, their emotional connection with their pets.So an example might be, if we're talking about periodontal disease or or any form of oral disease and to the halitosis that goes with that, once we've done this, you can get up close and have cuddles and kisses again without all that offensive odour.
Or if we're looking at resolving chronic parietus or otitis, you can both get a good night's sleep again here rather than both of you being up all night because of the scratching and so forth.So it's just zeroing in on what's important to them and what's going on for them as well as their pet.
So.So we we focus on the, the benefits.We do that from 2 directions, 1 is this is the benefit of doing this.And then here's the ongoing challenge or the risk if you like, if we don't do this because that will, that sort of orientation will connect more for some people than others and then we move it to the features.
And this is where we want to be really clear on what we're proposing and why and really building in value because very often it's thought by veterinarians that the biggest barrier to compliance is costs the the, the data suggested.That's simply not true.
Looking at a survey of pet owners that in fact the biggest money or financial issue is perception of value.And if I'm not seeing the perception of value, I'm going to delay a decision or I'm going to decline the recommendation.
And that's much more common than genuine affordability or or lack thereof.So really painting the picture of what we're, what we're going to do, that's making the invisible visible.Because because everything we do happens behind closed doors, and therefore whilst it's normal to us and it's what we do all day, every day, the general public have very little appreciation for the complexity of what we do and the risks involved and so forth.
Just just making the invisible visible.And that can be done through just working through a treatment plan.Here's what we're proposing to do.Here's all the things we need and focus on what the patient needs rather than the cost.And that can be supported by photographs, it can be supported by videos.
There's lots we can do to to really make the invisible visible.Once we've done that, we need to ask the client if they're happy to proceed once we've made our recommendation.And this is again where a lot of veterinarians fall down because they're so conflict averse, they will use inferential language.
This is what we could do.This is what we ideally do.We might need to do something about this in the future as opposed to here's our best way forward, here's why is that OK?And let the client decide.And of course, let them ask us as many questions as they may have as well.
And the final one is just avoiding buyer's remorse.Of course, buyer's remorse is that shift in decision after committing, which can be a real frustration to from the perspective of running our day if we've got procedures booked in and then people change their mind and just to decide not to, not to turn up.
Yeah.So that's a that's a kind of a very superficial view of something that that is is quite complex.But but nevertheless 6 steps that that with practice can become so where?In that division mentioned the money because we've I I understand that we've got to show the value.
Yeah, yeah, yeah.So all of that makes a lot of sense.But at what point then do you go and it's going to be X?So that's at that's at that fifth step.So we've talked about the benefits first, we've talked about the benefit of doing this, here's the upside, here's the outcome, here's the risk.
If we don't now we're going to move into the features.So when talk about it might be we're talking about anaesthesia and fluid therapy and the radiographs or the diagnostics, whatever it might be, the things that we're going to do and why we're going to do them.And and really there's a case of step by step this built in perception of value and in terms of cost.
Here's where.Here's where we're sitting at that.I love talking about that stuff.I'm proud that I know it and I'm proud of the services we offer for in my life to make it a selfish thing.It's emergency work.Almost always there was procedures of fairly urgent.Yes, thinking about the last financial situation I had was a big stitch of massive gash on the dog's back.
It's open.It can't really wait.It's got to be fixed and the price is fixed and it's not small.And the hardest part for me, I think where the elephant responds, where the elephant reacts is, hey, when you say their number and their base looks like you've just kicked them in the nuts or something like a gut punch, How much that reaction, I reacted and I know it's my own issue, but yeah, I don't know.
Is there something you could do about that?Yeah, Yeah.Can you guys recommend a random question?Actually, yeah, having a price list on a website or something like that.Because then at least there's not that surprise element.So when you talk about the stuff in the head, at least they're now probably opening out a couple of 1000 or?Yeah.
Look, I think the challenge for the priceless is there's so many complexities and unknowns and variables that that gets quite challenging average.Orthopedic surgery is 5000 or quite a bit, yeah.Look, I would say it's it's more about shifting the focus away from money and what we're tapping into.
I mentioned before that that and again, whether we like it or not, everyone of these conversations is essentially A negotiation and one of the most powerful negotiating tools that we have and we recognize it, is what's called the power of legitimacy.
The voila, the power of legitimacy.The power of legitimacy.Yeah.And a simple example of the power of legitimacy is a restaurant menu.The restaurant menu doesn't just tell you the various dishes on offer.It gives you a description of what you're going to get.
And then there's a number.And once there's a number and it's printed on paper, that's created a a sense of here's the proposition or here's the proposal And because it's printed on paper it's a non negotiable.
We don't ask the white staff.I I really would like the rib eye tonight but do you mind if I just pay 49 for it.It's a non negotiable and using a a treatment plan or a diagnostic plan in the same way we're instantly shifting the focus away from money towards here is what your pet needs or here is what we need to do to get from problems.
It's a solution and so it's it's very much about as I said the the the features of what we're going to do.Much of the rib eye comes with garlic butter and blah blah blah blah blah and and it's and by the way, here's what we're looking at cost wise.
Did you ever struggle with that when you need to save the dollar amount or I?Look because it's.Something that you had to work at?Absolutely, absolutely.I think it's something that most veterinarians have to to work on.What is exciting is that and I alluded to measurement when we provide and we've done this with well over 1000 veterinarians provide dedicated training to this to upskill in this also non-technical on clinical competency.
We have measured a almost 100% increase in a veterinarian's propensity to make a recommendation.And by that, let's go to the diagnostics rather than therapeutic trial or let's, let's take that option of here's what's best for Peace of Mind.
And we've also doubled the ability of a veterinarian to get their client to a yes.And and there is a win, win, win, win there because it means veterinarians doing the work that they were trained to do.They're achieving superior patient outcomes that's going to lead to a happier client and it also means that it's going to contribute to the commercial prosperity of the business.
So the the answer is that it's not a quick I'd say here's a here's a trick to make it more comfortable whether it is like anything.Practice.Your system get a.System get.Somebody to teach you practice.It and then practice.It and the other part.The other part of course is success breeds success.
So once a veterinarian starts to experience more yes's their confidence improves that it will make subtle shifts in tonality of voice, facial expression, body language, passion even.The one thing we say is that there is nothing that sells like passion and I don't want to offend anybody by using the term sell I I mean that but it's non sales selling but but that yeah when I say that influence clients to a yes with the best ethical recommendation.
Nothing sells like passion and the more confident we are the more passionate we are about it.The more passionate, the more the client is going to buy into that proposition and it's it's just a a almost a self fulfilling prophecy or a positive cycle.
The more uses I get, the more passionate I become.The more positive I am in my delivery, the more uses I'm going to get.And it can it can fundamentally shift a veterinarian's day-to-day experience.But the.Flip side, though.You talked last night about how how they activity bias.And when you have the, the bailer, the the, the real bad one, which is not that common, but it sticks with you.
So when you have the person who you do everything right, you think you do, and then they react in a really negative way.How much?That's ridiculous.All the stuff that we hear.Yes.And then that stings.And I feel like sometimes that's why I struggle because I've had a few of those.
And then you're so wary of getting that reaction again that you're actually nervous going in there because you're like, what if it fits one of those again?Yeah.Yeah.Yeah, where?Yeah, I.Get my head tooted off for just trying to offer the valuable, yeah?And look, I I I think there's two past this one.One is the recognition that that's Olympic response, that's the emotional response.
It's fight flight or freeze type reaction if it.Gets upset, yeah, yeah.Exactly, Exactly.When that client.Oh my God, that's ridiculous.What a rip off two things.Number one, that's kind of a a, a Specifically wired and and primitive brain response.
It's not not.It's kind of like, well, you know, risky threat, which of course is not really the, the threat that we feel in terms of physiological and emotional response.We have that red alert system.We don't have an equivalent green alert system.So every time a client says yes, that'd be great.
Thank you.Thank you so much for what you did.Yeah, look, that's expensive, but I get it.We're going to proceed.They don't have the same impact.It's a different wiring system altogether.They're negative responses, which is a peak out of the normal, and your brain goes watch out for those out of the normal with.
Up situation.Yeah, that that's exactly why you can have 2030 successes in a day and it's that one single one that question you that that that leaves the the impression and look I think the first thing there is to try and you want to approach this with curiosity if a client was to react with something like, well, you.
Get about the money, yeah.Or you get about the money.Oh my God, that's ridiculous, number one.And it's not easy to try and stay out of judgement because we that everyone's got a back story.There's a reason why they're reacting the way they are and there is a lot of gaps in their knowledge in order to to react that way.
The number one is to to try and stay out of judgement here and #2 is to approach it with curiosity and a really great simple technique to do that is with what we call a mirror.And a mirror is a specific type of question where we replay the client's last three 4-5 words just with an upward inflection I got that is a rip off, I'm sorry, a rip off.
And what that does is it transfers directional control of the conversation back to the client.So rather than us going into a defensive posture, we hand back to them with curiosity to let them explain or own what they've just said because that's an emotional response on their part as well.
And emotional responses are very often exaggerated and or embellished.So I'm just going to pass ownership back to you here.I'm going to let you control direction of the conversation, which avoids them being defensive.And it means we're not in a defensive posture either.
We're in a curious posture.I'd like to understand what you just said and and what makes you say that I'm sorry, and then repeat what they've played back to them.It also demonstrates that we're listening at at an unconscious or subconscious level.
When they hear their own words, they know they're being listened to.How does that conversation go?Let's say a guy goes, this is ridiculous.All you care about is the money.And I go, I'm sorry, all I care about is the money.Yeah.Yeah.Then what he he kind of go yes, like, how does how do these play out?
Yeah.So try it.So the the way they play out is entirely dependent on what the next thing we hear is.And this is where a fundamental skill that we're not that great at becomes really important.That's listening and we're not great at it because worldwide to listen to respond rather than listen to understand.
And So what happens is particularly if we're feeling threatened or or on a defensive as the message is being delivered to us, we're busily thinking about how am I going to respond to this, what am I going to say?And there's an element of emotion within this as well because this is offensive or it's off putting or it's upsetting there.
There is, yeah, it's going to take us off balance a little bit.So the next step really depends on what they say and we've got to listen to understand and and we don't know where that's going to go.Presumably it's going to go down like the the path of a gap in understanding between what we actually do and the client's perception of what we do.
And that's where we need to start educating and filling in those gaps.So you.Can't because I've I've, I haven't heard.And when somebody's in that a heightened emotional state they're trying to reason with them.They're going to achieve it.So explain it to them.I understand that it's a lot of money.We have wages of this and trying it doesn't normally work because they don't they don't they don't want.
Yeah.That they're wrong.Yeah.They just want to be angry.Yeah.Look, and that's going to depend on the emotional intelligence of the client somewhat.Low I'd expect normally, yeah.Be racking.Probably that's the case, not not great self, self regulation.
And one of the things I've found really helpful is to share or articulate.Clearly there is a significant disconnect between your perception of what we do and what we actually do.A great step forward or a great way forward would be for you to come in and actually watch first hand, not your pet, another pet having a similar procedure.
My experience was, and I'm not, this is not for everybody.I know that there are certainly veterinarians who are uncomfortable with clients watching their work, and I respect that.What I found was that most clients once I said that would say, oh, look, that that won't be necessary.
I guess I get it.OK, OK, let's go ahead.Once I was willing to demonstrate that level of transparency.This is an open book.You're welcome to look.I'd also had a handful of clients who said, all right, I will, I will take you up on that.
I'd, I'd very much like to watch.What was interesting was regardless of the magnitude of their emotional response in the 1st place they became our biggest advocates.Really seeing it first hand was what transformed people's perceptions and and bridged that gap, that that gap of analysts with respect ignorance.
Yeah it is.And and I heard on numerous occasions I had no idea.I will never complain about veterinary fees again we.Yeah, we're almost alone, but that opens the whole rabbit hole of open hospitals.
Yeah, Open Phoenix, which apparently solves a lot of those problems.Because people are there.Watching the action, yeah.We talk about perception of value.We we always welcomed clients behind the scenes unless there was something going on that was obviously inappropriate.So there was, there was rare occasions where we didn't do that.
But for the most part it was an open book.The team were comfortable with it.They were used to it.In fact one of our points of difference was that we had a beautiful purpose built hospitals, we'd like you to see it.The number of clients that said God, this is better than where I go.So you've said fundamental, make the invisible visible.
I once said reaction to a client, but it's actually helped me in the long run de escalate my own emotion and specifically that sentence.All you care about is the money, I've often thought.Why I feel like?That's the one we hate the most.To hear, Yeah, yeah.It's like the knife to the heart because it's.
We feel like it's absolutely not true.Oh, it could be.Further from the truth.But hang on, it's not.It's not entirely untrue.It's not all I care about, but I do care about the money.The reality is, it is my job.I want to get paid for it.So why?I don't recommend doing this, but it came out because it was three in the morning and I was tired and grumpy and the women just giving me a really hard time.
And she gave me that line and I responded.I said no, it's not all well, it's not all that I care about by by a long shot, but at 3:00 in the morning, I definitely care about the morning.Yeah, yeah.And.She was quiet and she couldn't really respond.She's like, and I won't use that to the client, but I almost say it to myself with somebody as that sort of, it's not entirely untrue.
I get less angry at the clients when they say that because I'm like, yeah, it is not, it's not all, I want the best outcome for your base, but I still want to get paid, yeah.Yeah, Yeah.Again there is that that kind of fundamental rule of reciprocity.There is a there's a two way exchange here and part of that is a financial one.
We've got to start wrapping up.There's a million things we can talk about that we're almost at the hotel and you were about to go and.Talk presents in three hours.We've just.Warmed you up now, in fact, we're your voice coach for future.I normally wrap up with a very quick one.Do you listen to podcasts?
I do favourites at the moment.My favorite podcasts?Tim Ferriss.Yeah, Sam Harris.Yeah, Peter, Tia, all of that.They'd be my top 3 then.Of all of them, good company.And then the last one.And this I usually give people warning for as well, which have a couple of minutes to speak to all of the veteran new grads of 2023, just to give them one message, one bit of advice or inspiration.
What is Gary's message?Wow, that there's some responsibility that goes with this.I think if I could deliver a message to and what I've seen in in new graduates today is you don't summit the mountain of clinical mastery overnight forever.
Yeah, it's a it's a journey.It takes time.Be patient.You will get there and recognize the the learnings because they're not failures.They're just learnings.I like.
Take your time.Yeah, I, I I'm going to disagree and say you're never going to reach this stuff, Yeah.Yeah, no, but.But it gets much prettier than how you yeah.Like like up on the.Mountain today, the higher the lift goes, the better the snow, kids.Yeah, absolutely.Yeah.
Now I think that's a nice analogy.Barry, thank you so much.Absolute.Pleasure.Thanks for having me.Before you.Disappear.I wanted to tell you about our new weekly newsletter.
I speak to so many interesting people and learn so many new things while making the podcast.So I thought I'd create a little summary each week of the stuff that stood out for me.We call it the Vet Vault 321 and it consists of firstly 3 clinical Pearls.These are three things that I've taken away from.
The clinical podcast episodes, my light bulb moments, the penny dropping, any new facts and the stuff that we need to know to make all the other pieces fit.Then two other things.This could be quotes, links, movies, books, a podcast, highlight, anything that I've come across outside of clinical vetting that I think you might find interesting.
And then one thing to think about.I'll share something that I'm pondering, usually based on something that I've read or heard, but sometimes it'll be just my own musings or rants.The goal of this format is that you can spend just two to three minutes on the clinical stuff and move right along if that's all that you're after.But if you're looking for content that is more nourishing than cat videos or doom scrolling, then our two other things should send you in the right direction.
And then something extra for when you feel like a slightly longer read.If you'd like to get these in your inbox each week, then subscribe by following the newsletter link in the show description wherever you're listening to this.It's free, I think it's useful, it's fun, and it's easy to unsubscribe.If it's not for you, OK, We'll see you next time.

Dr Gary Turnbull