Aug. 20, 2024

#127: What Veterinary Leaders Can Learn From Captain America, Getting Better At Giving Feedback, And How To Motivate The Motivators. With David Liss

#127: What Veterinary Leaders Can Learn From Captain America, Getting Better At Giving Feedback, And How To Motivate The Motivators. With David Liss

What do veterinary teams have to do with the Avengers?!
Discover how to transform challenges into opportunities and foster a culture of motivation and psychological safety across your entire team—from frontline staff to managers.
Here’s what you’ll gain:
Practical strategies to set team goals tailored to unique needs.
Insights on how to frame constructive feedback with empathy.
Proven techniques to involve team members in decisions, ensuring alignment with organizational values.
But that's not all. We discuss the critical (and often underrated) role of training managers in identifying gaps in skills and emotional well-being, equipping them to better support team growth. Plus, we tackle the art of balancing personal and professional well-being, navigating difficult conversations, and embracing feedback as a catalyst for success.
If leading your practice feels like assembling a team of superheroes, this discussion is your ultimate playbook.

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Season 1

You’ll hear a lot of complaining and blaming of leaders for everything that’s wrong with veterinary science. But the reality is that leading people is a very hard job, especially in a profession as complicated and nuanced as veterinary science. So this episode is for our leaders. We hope that it helps make your job of making our profession better just a little bit easier.

David Liss is the Director of West Coast Operations for Veterinary Emergency Group (VEG), and in this episode he’ll tell you about the three essential ingredients of great veterinary teams, and what this has to do with The Avengers and how they defeated Thanos! David also shares his strategies for giving hard-to-hear feedback, and tells us why goal setting is so important for building a great team and how to get the team excited for these goals. But we start with what might be the most important question: how do you, as a leader, stay motivated to keep motivating others?!

 

This episode was recorded live at IVECCS 2023, the conference of the Veterinary Emergency and Critical Care Society. Join me at IVECCS 2024 for MUCH more content like this, and more ECC clinical content than you could ever wish for. 

Get access to our highlights and key takeaways sessions, plus the show notes, from all of the conferences we’ve attended this year by joining our Vet Vault Nerds at vvn.supercast.com for more than 500 short sharp and practical podcasts in Small Animal Medicine, Surgery and Emergency and Critical Care. 

If you need expert help with those tricky cases that you can’t refer - we have a team of specialists on standby to provide you with some extra brains. Contact them here. 

 

Topics and time stamps

02:54 Motivation and Inspiration in Leadership

11:14 Back to the Avengers: Team Dynamics

15:43 Setting Goals and Achieving Buy-In

19:19 Profit: It's not a dirty word!

21:26 Handling Difficult Conversations

29:30 Carrot or Stick? Motivators

 

“5 Steps to Create Psychological Safety in Your Veterinary Clinic”

Psychological safety is the foundation of a productive and harmonious veterinary team. When team members feel secure expressing ideas, admitting mistakes, or voicing concerns without fear of ridicule or punishment, innovation and collaboration thrive. Here are five actionable steps to foster psychological safety in your veterinary clinic:

  1. Model Vulnerability and Openness
  • Why it Matters: Leaders set the tone for the clinic's culture. When you openly admit mistakes or uncertainties, it normalizes vulnerability for the entire team.
  • How to Do It: Share a time when you made an error and what you learned from it. This encourages staff to approach challenges as opportunities for growth rather than fearing judgment.
  1. Encourage and Normalize Feedback
  • Why it Matters: Feedback loops ensure that employees feel their input is valued, whether it’s positive reinforcement or constructive criticism.
  • How to Do It: Implement regular feedback sessions where employees can share their thoughts in a structured, non-judgmental environment. Use a consistent framework, such as “Start, Stop, Continue” (What should we start doing, stop doing, and continue doing?).
  1. Address Conflict with Empathy
  • Why it Matters: Conflict is inevitable in high-stress environments like veterinary medicine, but how it’s handled can either build or break trust.
  • How to Do It: Train managers and team leaders in conflict resolution techniques. When addressing disputes, focus on active listening and validating emotions before seeking solutions. For example, say, “I understand this situation is frustrating. Let’s work together to find a resolution.”
  1. Frame Mistakes as Learning Opportunities
  • Why it Matters: Fear of failure stifles creativity and communication. By reframing mistakes as essential steps in learning, you encourage a growth mindset.
  • How to Do It: After a mistake occurs, hold a no-blame review session to analyze what happened, identify preventative measures, and share lessons learned. Create a team mantra like, “Mistakes are tuition for growth.”
  1. Create a Safe Environment for Feedback and Growth
  • Why it Matters: Employees need to feel secure when discussing concerns or sharing ideas, especially about sensitive topics like workload or performance.
  • How to Do It: Start conversations with open-ended questions, such as, “What can we do better to support you?” Acknowledge their responses and take action to address concerns. Highlight changes made as a result of employee feedback to reinforce trust.

Bonus Tip: Leverage Positive Reinforcement

While constructive feedback is essential, recognizing and celebrating achievements is equally important. Publicly acknowledge when a team member embodies clinic values or achieves milestones, creating a culture of appreciation.

Creating psychological safety is an ongoing process that requires consistent effort and reflection. By implementing these steps, you’ll cultivate a veterinary clinic where every team member feels valued, heard, and empowered to contribute their best. This not only improves morale but also enhances patient care and client satisfaction.

“The Secret to Balancing Leadership and Self-Care in Veterinary Practice”

Balancing leadership responsibilities with personal self-care is one of the greatest challenges for veterinary professionals. With the emotional toll of client interactions, the physical demands of clinical work, and the constant pressure to inspire and guide a team, it's easy for leaders to overlook their own well-being. However, achieving this balance is essential—not just for personal health, but for creating a sustainable and effective leadership style. Here’s how to do it:

  1. Recognize Leadership as a Professional Role, Not a Personal Identity
  • Why it Matters: Viewing leadership as a professional responsibility rather than a personal identity helps separate your self-worth from workplace outcomes.
  • How to Do It: Frame leadership as a skill to develop, much like learning a medical procedure. This mindset allows you to focus on progress and growth rather than perfection. For instance, reflect on “What skills can I refine this month?” instead of “Am I a good leader?”
  1. Create Space for Private Reflection
  • Why it Matters: Leaders often carry the emotional weight of their teams. Regular reflection helps process these emotions and identify patterns or triggers that need attention.
  • How to Do It: Dedicate 10–15 minutes daily for journaling or meditation. Use prompts like, “What challenges did I face today, and how did I handle them?” This practice provides clarity and emotional release.
  1. Set Boundaries with Your Team
  • Why it Matters: Leadership often blurs the lines between personal and professional time, leading to burnout. Clear boundaries create a healthier balance for both you and your team.
  • How to Do It: Define specific “off-duty” times where you won’t check emails or address non-urgent matters. For example, let your team know you’re unavailable after 7 PM unless there’s an emergency.
  1. Seek Support for Yourself
  • Why it Matters: Leaders often feel isolated in their role, believing they must have all the answers. Seeking support shows strength, not weakness.
  • How to Do It: Build a network of mentors or peers in similar roles who understand the unique pressures of veterinary leadership. Schedule monthly check-ins to discuss challenges and share advice. Additionally, consider professional coaching or therapy for personal growth and resilience.
  1. Schedule Self-Care as a Non-Negotiable
  • Why it Matters: Self-care often takes a backseat to team needs, yet it’s the foundation of effective leadership. A leader who is mentally and physically well can better support their team.
  • How to Do It: Block time on your calendar for self-care activities just as you would for meetings. Whether it’s exercise, a hobby, or simply downtime with family, treat it as a mandatory appointment. For instance, schedule a 30-minute walk after work to decompress before heading home.
  1. Frame Challenges as Temporary and Contextual
  • Why it Matters: Leaders often experience setbacks that can feel overwhelming. Reframing these moments helps maintain perspective and emotional stability.
  • How to Do It: When faced with a challenge, ask yourself, “Will this matter in a month or a year?” This simple question helps zoom out and reduce the intensity of immediate stress.
  1. Use Your Team for Support and Collaboration
  • Why it Matters: Leadership doesn’t mean carrying the entire load alone. Empowering your team fosters trust and reduces your burden.
  • How to Do It: Delegate tasks and trust your team to handle them. Celebrate their successes to build morale and lighten your own workload. For example, assign a trusted staff member to manage the schedule or lead a client communication initiative.
  1. Celebrate Small Wins
  • Why it Matters: Veterinary leadership often involves long-term goals and complex challenges. Recognizing small victories keeps motivation high.
  • How to Do It: End each day by listing three positive things that happened, whether it’s resolving a client issue, completing a surgery, or seeing a team member succeed.

The Impact of Balanced Leadership

When veterinary leaders balance their responsibilities with self-care, they not only protect their own well-being but also model sustainable habits for their teams. A leader who prioritizes self-care demonstrates resilience, emotional intelligence, and adaptability—qualities that inspire trust and loyalty among staff.

Remember, leadership isn’t about being invincible; it’s about being present, reflective, and proactive in maintaining your own health and energy. By integrating these practices into your routine, you can lead with purpose while avoiding burnout, ensuring a long and fulfilling career in veterinary medicine.

There's always a lot of complaining about the bosses and the leaders of vet clinics, whether you're in a one man show where the owner is also the accountant and the HR department and the one doing the rosters as well as the number one consulting vet.Or you work in a corporate group that has more layers of management than a friend.
She has health problems.It's easy to point fingers at the inadequacies of management for everything that ails your working life, but the reality is that it's a bloody hard job.Animals are straightforward diseases.They're mostly predictable, but people, people are complicated and leading them is hard man, especially in our profession.
And that's the way I see running a veterinary business, too.It's incredibly nuanced and complicated.It's never all good or all bad.So this one is for our leaders because somebody's got to do it.And this conversation will hopefully help make it just a little bit less nuanced and complicated.You're listening to the Vent Vault, where we aim to inspire and empower by listening to the experiences and insights from the others who are walking this path with you.
And in this episode, you'll hear from David Liss.David is the Director of West Coast Operations for the Veterinary Emergency Group, or VEG in the US.He has extensive experience in our profession, first as a double boarded veteran technician specialist working on the floor as an ER ICU technician for more than 10 years, and then in several leadership roles for large 24 hour emergency and specialty hospitals.
His experience is complemented by an MBA and several human resources qualifications.And I had the opportunity to interview David to get some key takeaways from a couple of his talks at last year's IVEX conference, which is the International Conference for the Veterinary and Emergency Critical Care Society.
And the takeaways I've got for you from this are all gold.A conversation centres around one of David's talks that explained how running a successful veterinary team is a bit like The Avengers taking on Thanos and what we can learn from Captain America.I see two things going on in Captain America's head.
One is he feels defeated.He feels like he can't do this.But the other part of it is knowing Captain America, he's going to do it.He's going to run up to Thanos and he's going to swing the sword until Thanos drops his head off.How's.That dramatic music David will teach you about his three key tenants for great veterinary teams and tell you why goal setting is essential for your business and how to get team buying into those goals.
We also discuss how to talk to vet teams about profit.I fully ascribe that profit is not a bad word.I think it's silly if we don't talk about it because everybody knows about it.And because I know what a bunch of conflict avoiding nice people who are, I ask David how he effectively gives tough but essential feedback.
We also review some of his talk on motivation, how to decide what the best motivators are, not just for your unique team, but for each individual team member.But first, we begin with what might be the most important question.How do you, the leader, stay motivated to motivate other people?
Let's get into it with David Liss.Welcome to the couch with the red fault, Yeah.Thank you.The very last talk, my very last talk on the very last day of IBEX 2023.
Awesome.Thank you so much for having me.Appreciate it.You've done a lot of talking.Yeah, this is my last one.I'm done.I call it a wrap.So I one of the topics that you spoke about drew me because I'm a bit of an Avengers fan.Sure.Yeah.You had a topic that said how The Avengers beat Thanos.
Yes.Which has made me think a lot about how I didn't get the privilege of going to a talk because you're doing this stuff.I was trying to think, how did they be?I know how I've watched the movie.I want to start with there's a scene in one of the Thor movies that I really like for personal motivation.
OK, so have you seen Thor Ragnarok?Yes, love.That's one of the best parts in my opinion, yeah.So the scene towards the end where his sister, his evil sister, Hella, whatever, he's got him by the throat and his hammer's broken.He doesn't have his hammer anymore, so he feels useless and she's about to kill him.
And then Odin appears to him in a vision and he says to him something along the lines of what are you the God of?Are you the God of hammers?Right.The answer is no.I'm the kind of standard.Right.I I'm much more.It's, I'm not my tool.I'm not right.And then he realizes.
Then he kicks.Bad.Yep, Yep.So.What are you the God of?Oh wow, that's a good question.Oh my God.I guess I would say I'm the God of inspiration.I try very hard to personally, professionally and with teams that I work with, not let them see roadblocks as negative.
They're just roadblocks.I mean, there's always a way around it and through it.And I do that, I think by bringing an inspirational there's always something next, bigger or grander that we can work towards, which keeps people motivated.So.That's your leadership superpower.I think so, yeah.Motivation, yeah.Motivation and inspiration.
How do you?This is complete detail, but how do you do that without playing the GLAAD game like Silver lining?Don't worry guys, it's OK, because sometimes people want to be heard that there's a problem, right?And and just going it's OK, we'll get through it this way.Yeah, How?How are you not irritating when you do that?
No, absolutely.And that's a great point.I'm not a cupcakes and and unicorns kind of person.I do think that life is difficult and there's ups and downs.What I do think though, is that it's always really about the story you're telling yourself or how you frame it.So what I like to do exactly as you said, is let the person tell the story from the fear this, the negative land, you know, whatever, wherever they're in, meet them where they are.
And then I'd like to just ask questions about, you know, like if they, I'm trying to think of an example, if they say something, you know, I'll never this or this could never happen.And I'll ask questions about, you know, why do you think it could never happen?And that starts to dig into a little bit of some sort of story or bias or history or whatever, and it brings it forward.
And then when we're at that place, I then like to say, why do you think it could never be different?And then they're that elucidated something else.And then the last phase of that is there's always two paths.There's a path that it could be amazing and there's a path could it be terrible?But there's always 2 paths.And what that does, it starts to give them that little bit of hope that they can go down the path of amazing.
And I would say it could be terrible, could be mediocre in the middle, but it could be amazing.And that gives them this ability to move forward.I like that question.Is it is what you, I can't remember where I heard this or read it, but yeah, it's it's for any situation.It's basically something that that gets a negative emotion.
So everyday life or at work is to ask that question, is what I believe about this true?Yes.And then second question is, is it definitely true?Exactly correct.Give an example.That that I heard was somebody cuts you off from traffic and you you asshole and then you go, is that true?Is it definitely maybe he's not.
Maybe he didn't see me.And then the last question of if it's not true, what what could be the opposite of?100% that's the right way to do it.Yep, absolutely.And when we talk about motivation, so this episode will be for the team leaders.Sure, it's a tough job.How do you keep yourself motivated with it as well?
Because it's it's I see, I know many practice owners and as long as it's tough if you feeling to go in and then motivate the team and you feeling like all I can see is.That's a good question.I think there's kind of two parts to the answer.
So the first part is I see it as a requirement of my job.And so, you know, doesn't mean that I'm perfect at it all the time.No, but I have to not want to or need to, but have to be motivating or inspirational, whatever that skill set is.
And then I frame that by for my job, so I don't have to be it 100% of my life.I can take the time, I can play with the dogs.I can see a therapist, I can go to the beach, I can eat good food, whatever it is to then fix, you know, that part of it.The other answer, I think is that privately, meaning in my office or with a trusted boss or Co worker colleague, I can be not happy or be struggling with something or whatever and have them reframe it for me also so that when I go to work with the teams, I'm I'm better.
And I just also tell myself to, you know, like if I have an upset around, I don't know, I do a lot of operations.So a clinic's performance or how they're doing or all that kind of stuff.I just say to myself, again, framing it and contextualizing it.Have they always been this quote UN quote bad?Will they always be that?No.So, OK, hang on a minute, zoom out.
And that usually really fixes any kind of negative feelings that I have or struggle.And then I just tell myself it's a marathon, not a Sprint.That's great.The first part of your answer cuz it's a requirement of your job.Yeah.You're a professional.Yeah, I like that.Sometimes we go well, I don't feel like good.
Well, I like reading about writers and how they write because that's a tough job as well, and the most successful ones say it doesn't matter if I feel like writing right, I sit down and I fucking write.Yeah, might be rubbish, but I have a commitment.Absolutely.That's the difference between that somebody dabbles and somebody's a.
Professional, 100%, that's correct, yeah.Quick update on our clinical podcasts and then we'll get back to David.It's conference season here in Australia and I have been recording like a madman.I've had amazing conversations with amazing speakers about amazing topics.In the past month, I've learned about silent.
Regurgitation being a major cause.Of chronic coughing in a large percentage of your coughing dogs.About how to actually fix those poor constipated cats.How to get better at managing sepsis, fixing cleft pellets, diagnosing and managing pulmonary hypertension.How to save those fate cats.
And and and and and.I'm not even nearly done.I'll be back at IBEX again from 7:00 to 11:00 September, interviewing more of the world's best specialists.You should come and join me, by the way.It's epic.I'll put a link in the show description for you.And I'm not even quite done releasing recordings from last year's IBEX.
Of course, you can hear all of this on our clinical podcasts.So if you have FOMO about all of the good stuff at all of these conferences that you've been missing out on, we've got you back.Sign up now at vvn.supercast.com to get access to our conference highlight interviews, plus more than 500 other episodes in emergency critical care, small animal medicine and surgery, and of course, our beautiful show notes.
Oh, and on that topic, something to look forward to for our subscribers, I'm very close to releasing an AI assistant that intelligently searches our show notes to give you on the spot answers for your tricky cases using all of the content that we've ever covered on the clinical podcasts.
So for example you can ask it have.You covered well, I don't know.Hip displaysia anywhere and it will tell you that yes, back in episode 44 and in 78 on the surgery stream we discussed hip displeasia.Or you can ask it a direct question like can you tell me the recommended insulin dosing protocol for treating a dog with TKA and it will pull up information from our episodes on that topic.
I've been using it at work and it's really really cool.Our members will have access to this included in their subscriptions, but once I go live with this, the pricing for new sign ups will have to go up to cover expenses for the tech and the back end stuff that will make all of this possible.But if you Join Now or anytime before this happens, which is hopefully in the next month or so, you will be locked in at the lower price for as long as you stay signed up.
So go and lock it in now at vvn.supercast.com.That's vetvaultnetwork.supercast.com.OK.Back to David.OK, back to The Avengers.Defeat that us.Great question.So in the lecture, I reference a scene, and this is the classic scene where Captain America's helmets busted.
He is bloody, he's damn near crawling, and Thanos is sitting at the top of the mountain and the scene pans where it's all of his ships and all of his people.And it's interesting because I see two things going on in Captain America's head.One, because he feels defeated.
He feels like he can't do this.But the other part of it is knowing Captain America, he's going to do it.He's going to run up to Thanos and he's going to swing the sword until Thanos chops his head off.And then there's that kind of low on the music and behind Captain America, he doesn't see it yet.That yellow circle of Doctor Strange and it's Black Panther and his lieutenants that walk out.
He turns around and.Stuff I'm getting emotional, yeah.Right.I mean, it's just that everybody's sobbing, right?And he looks at them and there's this moment.I mean, it's literally an eye bow twitch or something, right?And you know, in his head he goes, I don't have to do it myself.They're there for me.And that's what I think is the key to how the vendors bet beat Thanos is they first of all, they realized that it was bigger than themselves individually.
It was a team effort.He wasn't going to beat Thanos.He was going to get killed, but the team had to be there.And that's what I like to translate to the veterinary teams is you can't do do it without a village, you can't do it without a team.So if you're not taking care of the team, motivating the team, managing the team, it's not going to go well, you are going to fail.
And you're not Captain America, right?Right.Right.No, none of us are you.Might think you have it, yeah.Exactly correct.Yep.And I think that's the really good kind of dichotomy where he he still has that and God love him, but that ego of I can do it and I'm going to do it myself.And then there I see in his eyes that moment of I can't do it and then the team comes in to save him.
And that's the ultimate just truth in that movie.So where?Do you go with your talk with that?Because it's a.It's a simple principle, but not always that simple, yeah.Absolutely.So what?What?What are the key tenants of you?Yeah.No, absolutely.So I'm not a huge sports fan, but I do use a lot of sports research and, and theory in that.
And again, I'm, you know, there's parts of sports that I think are probably somewhat toxic.But the idea is that if you look at sports and look and understand the team, first of all, you have a really strong leader, right?Which they call a coach.And that coach is not easy on the team.They're difficult on the team.But it's always done from love.It's always done from care.
The 2nd piece of it is that team is always working towards something and in sports it's this, I have to say.But this stupid gold trophy, right?I don't mean stupid in a pejorative way, but you know, it's not.And maybe some money, but it's not, you know, and a little bit.Of yeah.Exactly, right, exactly.
And so you, you can translate that into what the goal is for your teams.It can be something in like a general practice.It could certainly be targets, spays, neuters, dentals, clients, visits, whatever.In emergency practice, it can be that the goal is to, you know, save animal lives.And that's what we do.And when did we fall short?So when you get everybody focused on that goal, then you just continue to identify when did we fall short of the goal?
How do we get better at working at the goal?What that does is then it it kind of takes anything personal out of it, meaning I'm not doing poorly.Me personally, the team isn't the golden get met.How do we get better?People don't like their egos attacked directly.So when you make it about the goal, it it takes that off of it.
And then the third part is the team dynamics.So understand that it is a bell curve.You're going to have a players, B players and C players.There's going to be a few A players, players that formula for sex.You can't have all A players, it doesn't work.Few A players, several B players and C players that support the A players and also themselves have defined skill sets and that nobody's bad or good.
They're just part of the greater team.So what is each person's role and how does it fit?And then you work with each person in that role.You're either the, you know, you're the receptionist or you're the vet tech or you're the surgical tech or whatever.And you drive them to be really good at what they do.And then they're just part of that broader team.And so I think those big three tenants are what we dig into a little bit deeper in the talk, but round up to how to run this team.
And the reason why I think it's super important is that, you know, sports teams, they they kind of fall under this like high performing team banner intensity.Same thing with veterinary medicine, right?It's not, it's physical for sure, but it's not, you know, they're not running up and down a, you know, a mile, but it's emotionally and intellectually intensive and, you know, physically nuanced in terms of the skill set.
And so I call them high performing teams also.And there's a lot of literature that translates.So I'm going to pick one of those three tenants.The sure, the setting of the goal, the trophy, the goal of the trophy.And as you say, in sports, it's it's actually irrelevant.Yeah, it's.How do you?Set that goal for a veterinary team.
Yeah.And then how do you get buy in?How do you get.So look, it's easy enough to say saving animals because that's what we've signed up to.That's it's the it's the obvious thing.But beyond that, there are other goals as well.How do you get people enthusiastic about it?Yeah, that's a great.Question.So I think the first thing that you have to do is it can't be, it can't be one person's goal, meaning the one person's often the the owner of the practice or the manager can't be their goal because and they can have goals.
There's nothing wrong with that, but their goal is probably not going to be the same goals or even aligned with the folks that are on the front lines.It's not going to be motivated necessarily the same way.You have to let them choose it and buy into it and and, and somewhat create it.So I would incept it by, you know, having a team meeting and kind of talking through that, you know, having a kind of set of core values or a vision at the practice is really the goal.
The vision often could be the goal and a lot of literature shows that you want your team to engage in that process.So the goal is not going to be win the trophy, that it's not going to be short enough.It could be something like we strive to provide, you know, the cutting edge veterinary critical care to the community of Perth or Queensland or, you know, Los Angeles or wherever it is.
And if all the team goes, Oh, yeah, that really speaks to me, that team will fight for that goal every day.And then you bring back everything you do to that goal.Where did we miss it?Where did we do Well, what?What's the issue that's not aligned with the goal?And if you keep that language going, the people understand.That's the bigger picture to shoot for.OK.
So to make it really practical for you guys for veg, it's a big group.Now when you do this, two questions.Is this a veg goal or is it a which Denver goal like this?Each practice set their own individual girls like that.I know you have your your key values, sure.
Sure, sure, sure.But.But on a, on a practical day-to-day basis.And then the second thing is, it is, it's that right?Do you set new goals or different goals?Or is it just this practice?This is the flag we will stand by.That's.A great question.The nice thing about VEG is that there's really both, which allows for both a sense of think uniqueness at each practice as well as a roll up to the bigger company and the bigger mission.
So the bigger company goal, which every VEG has to be aligned with, is providing care for people and their pets when they need it the most.Any decision that is made that aligns with that is already, you know, absolutely OK decision all the way up to our CEO, David Bessler.So for example, if if you know, a doctor calls out sick, we don't have a doctor, you know, another doctor can come in, but they need this, you know, extra pay or whatever to do it.
If it's providing care to the people, there's it is approved, no question, right.So though that drives our teams to make decisions in that framework.That's the company goal.You have to align on that if you want to work for veg.Then at the individual level, David talks about his theory of cholent, which is this Jewish Stew and everybody's got a different recipe.
We encourage each VEG unit to have different ones.And so on the operational side, we have unique, you know, KPIs for the practice.How are they doing and what's their benchmark against what they did?The individual staff, you know, there might be a really high, a number of highly skilled nurses.So their goal is they want to get even more upskilled.A hospital might have less skilled nurses.
So their goal is to just get competent, right?And so every VEG kind of starts to build those in, which I think is is why we get really good buy in at our hospital levels.There's unique individual hospital goals that are local to them as well as this really greater higher purpose that feeds all of those things.
OK, so.There's a generalized why the how is determined more at ground level.How do we What do we need to do now to get better at that?Exactly correct, right.And that's the unique, right, because each hospitals, how they get there is going to be different depending on their kind of unique variables and characteristics.
Again, owners will listen to this and go.As you say, the goals are not always aligned right.For many owners, the part of the goal is financial success.Absolutely.Profit, yeah, for sure.Of your job as well, Absolutely.Yep.Does that come into the goals for the team as well or because that's often very hard to go well?
Why is my goal your holiday house right at the beach?Absolutely.Yeah, no, that's a great question.I fully ascribe that profit is not a bad word.I think it's silly if we don't talk about it because everybody knows about it.So I'm a big proponent of open book management.You know, depending on how transparent the owner wants to be, everything is done essentially within the guidelines of, of tax code, law or accounting.
So it's all publicly accessible.I mean, a, a shrewd employee could Google, you know, how do I depreciate a piece of equipment, right?So it's, it's nothing, it's nothing confidential.The specific numbers are, but not how it's done.So explain to them that here's what the business takes in.I think it's, you know when you look at for example, the profit margin, I think it's pretty eye opening when you say to somebody we take in, let's use an average $0.20 on every dollar I take in. $0.80 of that goes to the cost of goods, to the sale, to the payrolls, all that stuff.
And people usually go what?And I go, I give them a dollar and I say give me back 20 or, you know, give me $0.20 and they go what?That's really eye opening, right?So even the, the beginnings of the owners or the partners, which many companies have multiple people, they get $0.20 on the dollar, right?Then there's a bunch of stuff that comes off below that.Then whatever's leftover is distributed maybe to one person, maybe to 10, maybe to 50, right?
So it's not all, you know, it's not all one guy pocketing billions of dollars.It's not that moment.So I work through all of that with them and then I'm very clear on that, that there's nothing wrong with a capitalist society.The point of the business is dry profit.They pay taxes, they support the government.They also give that back to their employees.So I'm a big fan of either showing them that the retirement plan is a profit share because it is a contribution from the expense, or it's a true profit share where it is the bottom line.
Either way, I think can show the team that that's super important.So absolutely, it's part of my job.It's part of the job to drive it.I think the team can have a role in it.They can understand how to keep themselves efficient and lean and drive that.And the way that I also explain it and silly, but I think it makes some sense is that is the bank account of the of the practice when everything's said and done so that money can go into and fund raises or equipment or whatever it there is an unlimited money.
And so when I explain it to them in that way, I think that's where it clicks OK.That's great.So where do we have these values and the things that we decided we're going to strive for and agree on?And it doesn't happen.Yeah.Then sometimes you have to have difficult conversations.Absolutely sure, sure is that.
Part of your job, yes.For sure, 100% all the time you've got.To sometimes be the bad cop because yeah, yeah.Absolutely, absolutely that.Is hard I know there's there's a lot of data that shows that most of us in the vet profession are very amiable people right.
I don't really like conflict we choose to be vets because we want to help and I've been in a leadership role I ran a practice as well yeah.And I would walk around for two weeks before having to give the feedback, though.Sure that I don't like giving, Right.Absolutely.How do we make it easier or how do we do it?Well, yeah.
That's a good question.So, you know, no offense meant, but I'll call you out.It isn't, it doesn't get easier.What you have to recognize though.Yeah, right.You have to recognize that it is tough.And so I think we actually talked about some of this even in the beginning part of this podcast where you just kind of said you just kind of have to do it.You just kind of have to do it.Now, that doesn't mean that you should be terrified of it.
I think there's two things.One is understand that it's going to create some sensations in your body.You're going to be nervous, you're going to have dry mouth, you're going to trip on your words, all of that.Yeah.And if you if you give into that a little bit and understand it, you're not going to be this perfect.You're not not a news reporter, right?That's got a script.
Then it relieves some of the like perfectionist stuff that we have of how it needed to go.The second thing is just be in it with the other person.If you come at it from a, from a perspective of I care about this other person, doesn't mean you're not going to terminate them.And you might be caring about them while you terminate them.However, the decision is separate from the fact you care about them.
It relieves it, it, it soothes a little bit of that fear as well to just say, I'm not sure what's going to be the outcome of this meeting, but I need to tell this person that stuff.That is my job.It is my responsibility.It's also heck, my honor to tell this person that they're not doing well and it's fair for them to hear it.And then I'm going to get through it in a way that I feel is the most respectful, most professional and we're going to try to come to a resolution.
The resolution might be we didn't come to resolution and I'm the one in a seat of authority and I'm going to separate and in the relationship.But that can also be done with incredible generosity and heart and outside of the box thinking so that it isn't nasty and horrible and, and go go sideways.The other thing about this is that no employee should ever know they're going to get never, never know they're going to get terminated because you should have talked to them not 50 times, but enough times to say if this performance does not improve, something else is going to happen.
So the the doing it with care and doing it from a place of love, it's often, it's often not perceived that way.Sure.Especially when there's a lot of emotion involved.Sure.How do you do that more?How do you show that?How to, you know, let's say you're we're having a difficult conversation.Yeah.I'm not performing.How do you do it?What words do you use?
Yeah.Make me believe that.Sure.So, you know, the the ultimate theory or buzzword around this is called psychological safety.And the idea is that the person, if they're reacting to what you're saying and they're showing signs of it, so they're wanting to disengage.They've got, you know, body language that's showing you they're shutting down and not responding.
They're not feeling feeling safe.And so unfortunately in a termination conversation, the relationships going to end.But any other type of conversation, I call that out very gently and, and, and in a loving way.And I'll say, you know, Hey, I need you to respond.This is, you know, this is going to be part of what I need you to do.But it looks like you're not ready or you've got some thoughts that maybe you're, you know, safe feeling or you look like you're very kind of amped up right now.
Why don't we take a minute?Let's step back.Let me address the fact that you I think you feel like this is not a safe conversation.I understand how it can feel that way.What do you, where is that coming from?And they, you know, they often will say things like, I think you're going to fire me or whatever.And you can kind of work and say, hey, that's not this conversation we're having.
Doesn't mean it won't happen forever.But right now this is not happening.You can reframe it.The other thing that you can do is you can recontextualize the conversation and say, I just want you to know I am doing this because I care about you and I want to get better.And I'm going to show you how you can get better and I'm there for you.And, and that typically lowers the, the anxiety and the fear.
And once you've moved through some of that, then you can start to get them to crack the nut and open up and say I don't agree or I do agree, or, you know, I don't feel respected or I do whatever their responses are, which allows you to go down the path with them.Yeah, I like that where you actually pointed out if I if I didn't care, I wouldn't.
This is not easy for me either.But I care enough that I that I want to do this because I want you to to grow.With that, yeah, absolutely.That's.Really good.Yeah, this is something I've really found hard setting up that conversation, picking the timing and the place I was, I always got so stuck.
OK, now we're on shift together.I know who to talk to, but we're busy, so I can't talk to you now, right.If I tell you yesterday by e-mail hey, David, we got to have to shift tomorrow.You're in a Popeye.That's something I want to talk about.Yeah, they don't worry that you're going to walk around.You're not going to sleep tonight.You know what I mean?
Yeah.How do you set it up in a?In a way, that's because you've got a, yeah.So it like, you know, in the moment feedback obviously can be done right away if it's like on shift and you know, they missed a catheter and you can teach them.But a larger conversation is a great, great question.I would say the first thing that you're doing correct is you're thinking about it.
You're not doing a process like sending out a Google invite for two weeks from now and not having any understanding what that emotional impact is like for that person, you know, meeting with David dot dot dot right.You know, I try to just be very conscious of that.There are different ways that I'll approach if if it is a very, very serious, serious meeting, I'm not going to frame that it isn't.
I'm going to you know, we're going to set that up that way.But if it is a true just kind of quick catch up, I need to give you some feedback.I try to basically just be fairly casual about it because it is casual.This is not not.That means I don't want documented.Disciplinary hearing right?Exactly, And most people are going to perceive that, but I don't want to buy into that, you know, by by saying that it is or, or, you know, influencing that.
The other thing to do is the way to get around that is to have a lot of feedback so that when you have these conversations routinely with this person, it's less triggering and they realize that, oh, I'm just having a feedback meeting with David.It's not negative.I'm not getting fired for it.There's investment to get better and it and it deescalates that too.The first time you ever have it, they're going to be triggered.
You just have to know that.But I try to just have more consistent, you know, so if you say.Have those meetings on a regular basis, is that always going to be constructive feedback, not negative and sure or do you have a catch up as well and say look, I want to talk about the week and then it's excellent, you did really well then more of that you do do those as well.
You know they talk about you got to do 10 good things for every, right, Right.Yeah, I think you have to because I think you have to again destigmatize the, the, as you said, the negative, which is really more constructive conversations because those are always going to feel threatening and triggering to an employee.
So what I try to do, and this is sounds kind of silly, but as I try to have the same process, like whether it's, you know, the the wording that I use to ping them or e-mail them or I am in the whatever about setting up the meeting that I do with a good and a bad meeting.And the reason why I do that is so they just get used to having meetings with me.
That's exactly.What I'm asking, Yeah.Exactly.And so sometimes it is A and sometimes it's even in the same meeting.It's not, this is not all bad.You know, yesterday revenue was great.You know, payroll was off.OK, hang on.Revenue is great.Let's stay for that for a minute.This is what you did.Well, payroll's off.Let's talk about that.And it's so it's always, you know, it's always a a Stew of a bunch of different ingredients versus it's always just, you know, pasta with butter.
Like it's not all just one thing.It's very complicated, and that's the way I see running a veterinary business too.It's incredibly nuanced and complicated.It's never all good or all bad.And those sort of meetings, are they structured on a regular basis?Do you have set meetings with teams on, on, on feedback, good or bad, or are they generally pretty ad hoc?
Yeah, when there's something to another, great.Question I believe in both actually, because I do.I, I personally, I believe that we need to keep people on their toes.I think it's important because they need to be able to work through their own kind of emotional process and learn that that's happening in in different periods.Especially.
I just say most are with executive level leaders like hospital managers and higher frontliners.It's tough.I don't ask for that as much, but yeah, so weekly or bi weekly with hospital managers or that level and then a few ad hocs if there's a fairly urgent situation, meaning, hey, this is some stuff we just got to talk about now.And what I like to the reason why I do that is I try to desensitize the fact that I'm getting on a Zoom with you or or a meeting or an in person.
You almost know that it's not bad if that's what's happening because that's the process for or just working with somebody directly and closely.OK, great.Then so that's the difficult conversations.On the positive side, again, we're not negative necessarily, but on the motivational side, you had another talk that I like to talk of is how do you motivate teams?
Sure.The talk was characteristic.Yeah.So instead of short discussing characteristic right?Yes, right, Carrot.No, you know, it's funny because a lot of the people in that talk didn't even understand the reference and I just had to level set and say there's there's, you know, being a debate for probably, I don't know, forever in psychology around essentially negative reinforcement or positive reinforcement, right.
Do you beat them to get them to do something or do you give them a reward to get them to do something?Yeah, I know I didn't address.I'm sure that the veterinary behaviorists would have thoughts on what the right direction is.I do believe though, that we are both conscious and subconscious creatures.I think that there is an operating rating system that we have that we are not in control of nor mostly aware of.
And that's where this theory comes from.But what it does is it brings it out into the consciousness.So one of the things that I talked about in the talk is asking your teams what motivates them.Well, what questions do you ask, right.One of the questions that I think you can ask is are you satisfied with how often you get feedback from your manager?
And if somebody says they're incredibly satisfied with that, they're not going to be as motivated by, you know, saying getting feedback from the manager as somebody who says I'm incredibly dissatisfied with that.They want more feedback that person want.They're telling you they want feedback.How satisfied are you with your, you know, your opportunities for promotion that taps into a person's desire for power.
Power is not a bad word.It can be wielded in a bad way, but power is not.So if they say I'm completely dissatisfied, they want to be promoted.That's what they're telling you.And you've got to build that for them.So that's how to figure out what internally motivates your team uniquely.All right, so it's not a A in this practice, this is how we motivate, right?
It's like, no, no, we're going to figure out how to motivate each individual.Yeah.And I think that's important because so part of the talk we also talk about is even though the workforce is probably now it's over 50% millennials, it's probably closer to say 60% millennials.You have other generations that are in your workforce.You have other people with a variety of socioeconomic backgrounds and years in the field.
They probably aren't all motivated by the same thing.I'll give you one example.I did a survey and it's not peer reviewed, but I did a kind of ad hoc survey about this and the baby boomer generation, so elder 50s and up or motivated by quote the work.And I asked that question, what are you motivated by?And what I mean by the work, I think is, you know, this altruistic veterinary medicine calling less millennials were motivated by that.
And and not that they were demotivated by it was just a less of a group.And the way that I thought about it was they need the work and the work and dot, dot dot, because in the millennial frame of reference, if you've grown up in a millennial way in vet Med, you've had a lot of opportunities, you've had a lot of competition, you've got a lot of presence about the profession that we didn't have 2030 or more years ago.
And so your altruism or your desire is vet Med and good pay or vet Med and promotion, right?So there's more to it.And so that's what I took away from that, is that your employees are not the same.How old are you?Yeah.I'm 38, Gen.X, yeah, Gen.X correct, The forgotten generation, so.
What do we?Yeah.It's a great question.So, you know, it's funny when you do research or you look at this, first of all, I'm not, I don't totally buy into all of the stuff with the generations and I think there's some cockamamie stuff in there.But it's interesting because the Gen.Xers come typically come through from this.Remember Me, don't forget about me.
Huge populations, baby boomers, huge populations, millennial child.Yes, exactly.I'm not a middle child, but I, it's funny because I actually feel like that.And so a lot of my Gen.X colleagues will typically we, we keep our heads down, but we also go, wait a minute, don't forget.So they're motivated by a variety of of things for that reason, but one of them certainly is work life balance.
And it's funny because this is a an actually myth that's espelled, everybody thinks millennials were the work life balance generation, Gen.Xers actually were.But we're a small group, we don't have a big voice.So work life balance has been really important a lot of Gen.Xers because it'd be so.Apparent have that boomer mentality of the work exactly correct, right, right.
And it was also, it's interesting too, because it was a blend.The essentially the kind of the younger boomers that started to get their peaks in the 80s, frankly, in the US especially, made a lot of money and the economy was incredible.So they started to say, wow, I have a lot of expendable income.I can start to plan my family vacations and do all these things.
So we grew up with that.That wasn't in the 20s and the 10s, you know.So we said, OK, we go to work and we get a vacation every year.We go to work and we get a nice car.We got, you know.And so it started to build into that.And then we bled it on to the millennials who have taken it in a much larger voice.Yeah.Wow.
Great question.Practicalities is often, again, lovely principle.Find out what your what your team wants.How do you practically do it?It's a it's a big team.Yeah.You can send out a survey and then 80% of people don't do the survey.Oh, right, right, right, right.How do you make it happen?
Yeah, get the data.It's a great question.So a survey is a tool for sure.I would start even bigger and start with conversations about the team and say we're going to start either either we don't do this or we do.We're going to start having a culture of feedback, myself, ownership, management, whoever want to know what you think about the company, the hospital, benefits, opportunities for you, things like that.
You, you can say motivation, but that probably is going to turn them off more about what's in it for them type of wording.And then when you start to open up that, give it a little bit of time for it to settle.I would do it.It's in staff meetings.I'd start to get that feedback and then introduce the tool of the survey.The reason why people don't do surveys because they don't know what's in it for them.
If they now know that this survey is going to reflectively say, for example, expand benefits, change benefits, you know, lead for something in some way to them, they're going to do it.And so then you do the survey.That's one way to gather the information.You can also create questionnaires where the teams can do one on ones and ask those questions.
They're probably not going to be, you know, if you ask somebody like Howard, you know, strongly disagree or strongly like they're not going to answer that well in a one-on-one.So I, I think a survey is a great tool.And then if you have a team of 30 or 20, the manager can probably handle that.But if you have a team of 150, you probably need to have somebody centrally manage that and then disseminate out the results by department or lead or shift supervisor or whatever, and then give those people that information.
I think there's two sides of it.One is what is the personal motivator for the employee that a frontline manager, middle manager could use an influence.And then the bigger roll up is what can the company do differently?So for example, you know, you think you have great benefits, you know, it's, it's a PPO plan and 90% of your employees says the insurance is not great.
You have to do something about that, right?You can't put your head in the sand.So that information goes up to the top and then you want to show the employees that something came out of that.This is what happens.A lot of companies or a lot of hospitals will do a survey because they're told to, they see it on, they go to a, you know, they go to a talk or they during COVID, we do a lot of this and then they never do it again.
What do you think's going to happen when five years later you say, oh, we're going to do it again, Nobody's interested.It's been deflated, right?So you have to come up with a process and then repeat it over and over and make changes.I listen to this and I go because a lot of you guys are a big business.You got sure.And I'm I'm part of a big business as well where there's back in and there's management, there's absolutely HR group who can do these things.
But for a lot of people it's still it's my practice.Absolutely.And it's a lot of it's a lot of work.Yeah, absolutely.But then you see people complain about I can't get buying from my staff or my staff and I don't winge about it.But then I listen to this and I go, yeah, but it takes work.
Yeah, absolutely.Same thing.Are you being a professional about it?Are you expecting them to just do it?You got to make it happen.Absolutely.Agreed and that's where I think we go back to the, you know, beginning around like looking at roadblocks and moving through those.For example, one of the things that pops up into my head is, you know what, even in a small business, 2030 employees, what could you outsource or move off of your plate?
Payroll's a great example.You can do a PEO, you can do third parties.That frees the manager up to do more of this stuff as employing I was.About to say, if you're the owner manager, it's very hard to have time to make a survey about what your employees want to be motivated.If you're working 50, if you're on 2450, absolutely it's.
Not going to happen.Right.Right, go to surveymonkey.com or you know, quiz litter.There's a money on everyone.So you probably got to sign up for one year.You type in employee engagement and you get 32 templates and you just, Yep, grab one of those and send it.So, you know, we also often think we're on an island.We have to build it ourselves.
There are so many opportunities and there's now with so many like startups and tech companies and stuff, there's lots of tools for small businesses to run this stuff.A lot of third party, I don't have any names on my head, but a lot of HR and payroll companies that look at small business will have some of these tools to pull surveys.So definitely I would say that these roadblocks are all easily moved past to get you to the goal of having more motivated, more engaged employees.
We started with the movie.We'll wrap up.Did you watch the Ted Lasso series at all?I.Watched a little bit.I'm not not, I did not like it.I'm just guilty of not having finished it.But I know it's a cultural phenomenon.I think it's it's a moment, it's a textbook in leadership, absolutely.
Yeah, what made me?Think of it, is your the feedback?Yeah, So episode one, one or two, it's a very dysfunctional team that he walks into.Yes.And he puts a shoe box with a slide on the top and says suggestions and 90% of the pamphlets that he gets in there, says Wanker.
And one says.Oh, the water pressure in the showers is really crap, and then nothing gets said and then the next day shower and then turn it on and it's really good pressure, right?And it's such a moment.Yep, you can just see it.The whole was like, oh, I said something and something happened, right?And you're, and you're totally right.
I mean, I think you know if you, it sounds funny, but it is true.And you have to get rid of it.If you go into management to be liked, you're in the wrong job.It's not about them liking you.You have a job to do.And part of that job is hear feedback from them, get shit done about it and sometimes.The feedback's going to be rank exactly.It is sometimes they're going to they're going to rake you over the coals.
That's actually part of being a manager and it's just embrace it.Fantastic.David, was there anything else from your talks that you've watched your audience and saw light bulbs going off or something that or soapbox or anything at the moment that that I've missed out on?Yeah.You know, it's small, but I think it was quite funny.
So I made a joke.A lot of folks that are in training roles, which I think is kind of new now, came to my talks.And the joke was, you know, they said, oh, I said, you know, hospital manager, practice owner, you know, shift supervisor, whatever.And then I said anybody you know in training, training manager and a lot of hands come out training being.
Setting programs for training Exactly.Yeah.So I think it's.A mix of yeah, like writing SOP's and and, you know, recording lectures as well as like showing people how to do stuff.Yeah, exactly.And so I joked and I said, oh, so you guys have all the responsibility and none of the authority.They laugh because these guys are not managers, but yet they're working with people and finding deficiencies.
And so a lot of their questions were around, hey, I identify these either skill deficiencies or frankly EQ or EI, emotional deficiencies in these team members.And I roll it up and I see nothing get done about it.So I would encourage practice owners and managers, if you have training folks understand that they're in a very difficult position 'cause they're not managers, they don't have like higher and fire authority, but they're in a really unique place to get a lot of feedback from the team and hear stuff and see stuff happening.
You need to take that, and you probably need to do something about it.And.Also, because they're not in an authority role, they can't fire you, they can't get you in trouble.They will probably hear more, absolutely.They'll get more of the voice from As it Is on the floor.They're.Trusted and safe confidants.And so they're actually great tools for managers, but you can't let them, you know, go on forever.
You can't hang them out to dry.You got to do something about it.They're giving you this feedback.Awesome.David, thank you so much for sitting down even after Oliver talk and for all your insight and wisdom.That is really cool.Absolutely.Thank you so much for being here.It was great.Appreciate it.This.
Conversation was one of the mainly great non clinical conversations I had at IVEX 2023 and I'll be heading back to IVEX again this year in Saint Louis or Saint Louis.I don't know how you say it.If you.Haven't heard about IVEX yet?It is the conference of the Veterinary Emergency Critical Care Society or VEX, which if you have any interest in emergency medicine is a must.
VEX membership gives you access to a large library of clinical and non clinical resources to help you in your ECC journey, including the Journal of Veteran Emergency Critical Care, discounted access to IVEX, as well as discounts on a very long list of other educational and well-being resources, including discounted membership of our very own Vet Vault clinical podcasts.
You can become a member at vex.org.That's vecs.org or with the link in the show description.

David Liss