415 - Modernizing a Practice Without Making Everyone Feel Obsolete

0:00Ten years ago, I thought people came to conferences for information. I was wrong. You can Google almost any answer in 30 seconds while hiding in a supply closet. What you can't Google is skill. Skill is having hard conversation when you're exhausted, short-staffed, and the person across from you is upset. And that only comes from practicing with people who will tell you the truth when you miss. That's what Uncharted is. On Friday, January 15th in Orlando, the day before VMX opens, we're celebrating 10 years with a one-day conference built around leaders practicing hard things together. You'll get Dr.

0:37Peter Weinstein, the Uncharted team, and about a dozen mic drop talks from people in the community, people you know like Dr. Phil Richmond and Dr. Caitlin DeWild. I'm not going to tell you it'll be easy because it won't. But if you want to do the work alongside people who get it, come and join us. details are at unchartedvet.com register today don't miss your chance welcome back to another episode of the uncharted veterinary podcast i am your host maria prida and i am super excited for today's episode because this is probably the best mailbag we've ever gotten is turning off so kind and so wonderful and this person has a great problem at hand they are opening up their second location which is already kudos to them and in general they've got a great team the only problem is their medicine is stuck in the 2000s that's right it's 26 year old medicine and this practice manager is concerned because they want to improve the quality of the medicine but they don't want to hurt the team's feelings they also notice that they've been doing a lot of spectrum of care they really want to do what's possible to take care of the patient and the client and at the same time this practice manager is like, but we can still recommend gold standard care.

1:47So how do we do all of these things? So Andy and I talk a lot about identity. We talk a lot about how to get this change going, what not to do. And overall, it just becomes such a great conversation. So if this is something that you're needing in your practice, go ahead, get your coffee and let's get into this episode. And now the Uncharted podcast. You show up for pets every day. It's because Because care is your calling, and it's ours too. We know it's what drives you to make a difference in the health and well-being of every pet. That's because at Zoetis, hundreds of veterinarians are part of our team too, working with you to provide science-backed medicines, technology, and practical support to help elevate your standard of care.

2:36Learn more at careisyourcalling.com. Yep, I consent to being required. I consent to being recorded. Do you consent? I do. That's pretty good. I appreciate being asked, though. It'd be really hard to do this podcast if you didn't consent to being recorded. That would make the podcast very challenging. I was like, I don't consent to being recorded. Let's. Sorry. That's just us talking without the podcast. Our one-on-ones. That's literally what we were just doing before I hit record. I know. I know. That's exactly what we did before we pressed the record button. That's the whole first. That's possibly my favorite part of the experience.

3:13Before we actually record, everyone should have heard what we were talking about. It was crazy good. It was so wild. We are so wild. I'm going to go ahead and spoil a massive surprise that you are going to really appreciate, Maria. Oh, really? I've told my family, I was like, I've ordered something and it's coming. And they were like, what do you got? Like what? I'm like, I'm not telling. And then yesterday I was like, I got a tracking notification. and the thing arrives tomorrow. You're just teasing your family? And our lives are going to be different. I'm not. I got a two-pack of hummingbird helmet feeders.

3:49You know what I'm talking about? Wait, the one you wear? Yes, the big red helmets with, like, a clear face mask that have hummingbird feeders built in. I know. And so, my guy, I got a two-pack. Okay. So me and my wife, Here's the picture of Andy riding off in the sunset. Me and my wife on a porch somewhere holding hands with big red helmets with like clear plastic face visors and hummingbirds just feeding inches from our eyes. That's the golden retirement that I want to have. So will this package arrive by the time this episode airs? Oh, yeah. It's coming today. Like it should be here today. It hasn't arrived yet.

4:34All right. Well, then we're going to need pictures to include in the video side of this podcast because you can't leave people hanging out. I know. I'm telling you. First of all, the unboxing in front of the family is going to be great because my teenage daughters are not going to know what to make of this. And I am not kidding around. It's like everybody put on the helmets and get used to them. And then. So like, Dad, please don't do that. I got to tell you, it looks as mega dorky as it sounds like it's going to be over the top. And so, yes, there will be lots of filming of me sitting outside with this thing on my head.

5:07But I'm not going to show all the times that I sit out there and no birds come to me. You're only going to see the final success when there are hummingbirds swarming my head. Swarming your head. And this huge smile of success and satisfaction is on my face. I have so many questions. Like, where does the feeding come from in the helmet? I haven't got the hell yet. There's got to be a reservoir. The reservoir has got to be on top of the helmet. It's got to be. Well, it's got to be somewhere where you can see them, too, right? Yeah. Oh, you've got to put the water, like the sugar water in there. And then the big flowers are, like, stuck to the face mask so that you're looking at it.

5:44Anyway, I'll send pictures. We need photos. We need photos. It's going to be great. It's going to be great. So that's the most exciting thing in my life as a man of a certain age. that's a it's a big big uh moment in in your life i think oh yeah helmet is that's gonna be fun well not even your age there's no ages tyler herring on our team yes first of all is obsessed with hummingbirds she's an old soul tyler tyler was the first person that i knew to pick up pickleball like she's she is an old soul like there is her chronological age is 70 for her what no her her Not chronological. Her, what is it?

6:26Her mental age is 70. Yeah. Her chronological age is much, much, much, much younger than that. For Christmas, I got her a puzzle piece organizer so she could maximize her puzzling. So, yes, I totally see that. I think we're getting a picture of who Tyler Herring is right now. I think we are. I think we are. I think she's going to be, she's going to think this is amazing. She's going to be somebody's bridge partner soon. Yeah. That's happening. She's like, I've never taken up bridge, but that sounds interesting. All right. We need to get to work. All right, we should get going. We should get going.

6:56We have an excellent mailbag, which I have to say. It's one of my all-time favorite mailbags. Yeah, it's one of my all-time. It's funny. It's great. And it opens up saying, this is my second time writing. The first time I wrote, you guys gave me advice, and it was phenomenal. And it went really, really well. I know. And the doctor we coached is still here, and they're still the same person they were before. but they fit right in with our team and we all work together and we are a big happy group and thank you and i was like this i don't even know what the actual ask is but so far i'm really liking where this is going and it was like a good three paragraphs of that first oh i read that many i read it multiple times it was warming my heart so much i love it and i have to say they even started but now we have a different new but exciting problem and isn't that the mark of a Successful practice.

7:50I love the positivity. So they've got a problem. And one of the things that I love about this group already is they seem to have a very healthy mindset around that problem. And they seem to be going, you know, we've got a new exciting problem. And I go, I really like your headspace. I really like where they're coming from. I think that there's something to be learned just from, you know, if you can frame a problem up as a challenge, I think you're doing better than if you frame a problem as a problem. I think if you can frame a challenge as an opportunity, I think you'll do it even better. It's like, I think that mindset, I think it matters.

8:25And so anyway, I love the mindset of framing a really exciting new problem. Yeah. And I have to read this part from the mailbag because it gets to the crux of it. But also the way they wrote it is so funny. They're like, we are purchasing our second location. They have a good reputation. And there are some good people there who truly seem to have their hearts in the right place. But clinically and operationally, they are stuck in the year 2000. And listen, I like shimmery eyeshadow platform flip-flops and butterfly clips as much as the next person. But at this point in my life, it's probably time to hang up the extra low-rise jeans and tube tops.

8:57Luckily, some things like the internet that is only one step above dial-up are easy enough to fix. And then she goes on to continue to tell us what's exactly going on. Yeah. I want to pause here for a second and say, someone using the year 2000 as like a marker of being old, like that i felt really attacked i was like wait like 1990 doesn't feel like that long ago to me but no she was like 26 years ago she's like like we weren't in carton buggies in the year 2000 just so you know like like dr drace the chronic album had been out for like five years at that point like that's not that long ago no i mean you're right it wasn't that long ago i love that they because they kept talking about it later on.

9:43Oh, I agree. And Justin Timberlake. It was so funny to me. It was funny. It was hurtful to you. It's like she was. They went on and talked about it like I would go on and talk about the 70s, right? I would be like, yeah, let's watch some John Travolta and hit the disco, you know, and like, no. That is so funny because I did not see it that way at all. I wonder why. I was like, I wonder why. It's just one of those things where I was like, oh, yeah, yeah, that was a long time ago. so long ago i'm crying i'm literally crying right now that i'm laughing so hard that is so funny no overall i mean if you look at it it was a long time ago for medicine we didn't have stem cells no i get it no i get it you know like it was a lot anesthesia was new we were just we mostly you know we mostly was dial-up yeah telly netflix was still i don't even know if netflix was Oh, actually, not a thing about it.

10:38Netflix was absolutely out. They were just mailing DVDs. They were mailing the DVDs? They were. I had a membership. I was there. In 2000? In 2000, yes. I was in 2000. I wasn't even in college in 2000, Maria. I lived in Washington, D.C. I had a job. I had a PlayStation 2. Now they're on like six. I watched Netflix when they sent me things in the mail. All right, let's actually do this. Here we go. All right. Okay. So they've basically, they've got existing doctors. The issue is they think that they're going to be receptive to some changes, but there's some that they feel like are, they're going to like pearl clutching levels of things that, you know, they don't think they're going to, they're going to change.

11:21And they also said, you know, I am a huge fan of spectrum of care, but I believe that owners deserve to know gold standard and be given the opportunity to choose the level of care for their pets. And so the, the whole thing is like, she wants to make sure that she can bring in change as she takes over this team for the second location. However, she doesn't want to make them feel bad. She doesn't want them to get defensive. She doesn't want them to think that they're outdated necessarily. And so her main question is, how do we upload 26 years of veterinary medicine updates without crashing the system?

11:52How do you modernize the medical standards, client education, and team expectations in an acquired practice while still honoring the people who built the reputation you just bought? Yeah. That was beautiful. I thought that was great. The way I took this from her was these people have shown a willingness to change for sure, but there's a lot that needs to change. You know, like the whole place. It sounds to me like the whole place, the physical appearance of the place. I'm assuming the web presence of the place. Like she made the joke about the dial-up internet. You know, like the whole place is kind of a time capsule from 25 years ago is what it sounds like.

12:26And it's staffed with really nice people. And we want them to update. But, and I think this is the real question, and I think it's a great question. When you've got a big change like this, how do you bring people along without making them feel continuously nitpicked? Or, you know, like, hey, we're doing this differently. Hey, we're doing it. You can't do it that way. Also, the other thing, you can't do it that way. You can't do anesthesia like that. You can't do dentistry like that. You can't do surgery like that. You can't do vaccines like that. You can't do animal handling like that. You know what I mean?

12:55And like, how long until they're like, I'm trying to get with you and where you want to be. but this is just, I feel constantly like I'm being told I'm failing or I'm not good enough. And like, so I read it as how do you make that not the experience? And I thought that was, again, I love the foresight here. I think they're really thinking about this and what they want it to be. And so anyway, I really, I really liked this a lot. I've got some ideas off the bat for like a headspace. What are you thinking here? Well, I think I've obviously wanted to celebrate this person as a brand new problem. I agree with you.

13:26I feel like a lot of times what we see as practice managers, whenever they're taking over a second location, that's what they want to do is they immediately want to go in and fix all of the things that are wrong and change all of these things. But the team is going through a change, is going through transition. They don't know you. They don't know your leadership style. And so oftentimes I think it's one of those areas where sometimes like we have to slow down and we have to get to know the team and we have to build trust before we implement these changes. And I think that that's exactly what's on the top of mind for this person.

13:52And so I think that from a Headspace perspective, I just want to honor that for a moment and give them kudos for, hey, this is a brand new challenge. Hey, you guys are growing. Celebrate that. And hey, also, this is a really good way to think about all of the things you're going to be doing. And so from a headspace perspective alone, I just was like, you know what? I like that. This person's awesome. This person's awesome. I like that a lot. I want to pick it. I want to pick that back up because I think I think that you're spot on. I agree that from the outside, there is a strong desire to go in and fix things.

14:20And I would say one of the ways you screw this up at the beginning is you look at this practice and you're like, I need to fix that practice. And the answer is, no, you don't. You need to lead and inspire the people inside that practice to fix the practice. And if you think about it that way, then we can help to keep these people on board. You know what I mean? It prevents it from becoming, I'm trying to fix this and these people are stopping me or they're not getting on board or they're undermining what I'm doing because they are going to undermine what you're doing. If you go in there and don't get any buy-in and start changing things, as soon as you leave, they're going to go back to doing the old way.

15:00And this is just going to be kind of this war of attrition where you show up, battle a little bit, and then you leave and they rebuild the defenses while you're gone. And so I don't like that. If you can just go ahead and see the problem as not, I need to fix the problems. It's like, I don't know. So I was doing an escape room with my wife recently and there was this puzzle and it had like a magnet and you had to use a magnet to like drag a ball through a maze, but you couldn't just touch, you couldn't just move the ball. You had to use the magnet to push the ball and then the ball went through the maze.

15:29It's kind of like this. You want to just walk in and grab the ball and move it to the end of the maze. You cannot. That's unless you want to be at that building all the time and try to incorporate yourself into it. You're not going to be able to do that. You have to use the magnet to get the ball to move where you want it to move. And then the ball has to move and then you get to the end of the maze. So anyway, it's a bit of a stretch, but you get the idea. So I like that a lot. Number two, and I want to shout out something else that I really like about this question and the framing that I'm hearing.

15:56And this is really, really important. The decision to buy this practice has been made. It is done. We are in this now. And so you might as well get excited about it and be aspirational about it. What happens a lot is that people are like, we got a new practice and oh my God, we've to fix all of these problems and we've got to get these standards up where they need to be and we've got to make this thing profitable and boy it's going to need some real reconstruction and some turnaround that i hope we didn't bite off more than we can chew and this is going to be a lot of work and all those things are true but i have found that it is of limited value and it's definitely limited enjoyment to approach a problem like this using fear as a motivator i'm worried this is going going to fall apart.

16:46It's not going to fail. It's not going to work. People are going to revolt. It's going to be a quagmire. You know, like you can have those thoughts and they can motivate you to work hard. And some people use fear as a motivator for themselves. It takes a toll on you. The other thing is, especially in vet medicine that has compassionate, big hearted people who really tend to want to work for meaning and purpose. Fear is not a driver that works very well on them. It makes them unhappy and uncomfortable. You know, it kind of robs them of the joy that they try to find in this profession. And so if you want to do this project and you want to do it well, look, you're in it now.

17:24You might as well decide what your aspiration is and chase that instead of saying, we can't fail. Say, we're going to make this amazing. We have the opportunity to have this second practice to build something really special. We're going to be able to work together. We're going to be able to cross train. We're going to be able to help relieve staffing pinches by moving people back and forward. We're going to be able to, you know, centralize our record keeping, improve our customer service because we can have calls split between the different, you know, different hospitals. We might be able to have to extend our hours because one hospital is going to see stuff in the evenings and one's going to see them in the weekends.

18:04Like, I don't know, But like, what is the thing that you're excited about building? Why did we buy this second practice? I bet that there's a reason there. There was opportunity there. And if there wasn't a reason, we need to find a reason or create a reason that we can get excited about. I want you to chase the dream and not flee from the fear of failure. And I see a lot of people who are like, oh, crap, we did it now. And everybody is super stressed. And it's like, look, you can be stressed or not. It doesn't change anything. and like it you know you need to work hard no matter what but you can work hard for something that you're excited about and leading from that point of aspiration is going to be far more motivating for the people in the new practice than rolling in and talking to them about what we have to change and how we're coming up short and so what is that aspiration what are you trying to build make sure that you're motivated by a sense of hope and possibility for this place and that you're not motivated by a feel of failure.

19:03You're going to feel some concern, some fear. That's only normal. That's human. But that should not take up more time in your head than the aspirational things that you're hoping for. So that's the big thing for me is I want this person to be excited about what they're doing and where they're going. And I get from this letter that they are, and that makes me really happy. And I say, hold on to that. Hold on to where you're going. And so there's that. And the last headspace for me is you can be super positive. You can have big aspirations and big hopes for where you're going to go. And some people at this new practice might not want to come along.

19:42Yeah. They didn't sign up for what you're trying to do. They just did it. And I hope that that's not the case for any of them. I really do hope that. But I have to say the chances are there will be at least someone who likes it how it was and does not like where you want to take it. That does not make you bad. That does not mean that you should not do what you want to do. You have bought this practice. You have taken on this risk. You have taken on this work and this job. We choose how we suffer. Do you want to suffer by having to part ways with a person or two that's like, I don't want your vision.

20:19I don't want that. I don't want to be a part of that. Or do you want to suffer by having a saboteur inside the building who's there full time, subtly undermining what you're doing, pushing back, not being on board, sitting in meetings with their arms crossed, muttering under their breath, agreeing to your face that they're going to make changes and then not making changes when you're there. Is that how you want to suffer? And so I had a mentor and he would have a practice that he'd acquired and he would go in. And part of his speech was this. He would say, I want you to be here. And if you don't want to be here because you don't like where we're going, I understand that if the vision that I've laid out isn't motivating to you and you don't like it and this is not going to be the place for you, then we can part ways and there's no hard feelings and I will help you to get another job as best I can.

21:15Yeah, what you can't do is not be on board with what we're doing and stick around. And so, you know, you guys think about that. Ask me any questions that you want in the coming days or weeks. And, you know, and let's talk about it. Now, I don't walk in and I wouldn't say this to a group. But if there was someone who I started to see pushback with, if there's people who are not going to be on board or they're going to be people who are frustrated or they're complaining or they're just not complying with where we're going, I think that that's an important thing is you can be here and that's great.

21:46Or you can leave and that will be sad, but I will support you as best I can in leaving. But what you can't do is stay here and not be on board with where we're going. And again, I think that philosophy is very healthy and it sets good expectations for you as the leader. And again, hopefully we won't have to have that conversation. But I think that if that's your mentality and you can truly be OK with those options, I think you're going to be in a good headspace to start making some changes and to move this thing where it needs to go. There's so much that you talked about just now that I think I really love in the sense of, you know, obviously, I do think every time we have any kind of management transitions, you tend to see some people just not be able to be on board and you either quit or you leave like that.

22:28That's a very common thing to see. Yes. And I think we even see that sometimes when you bring in like a rock star who is kind of elevating the team a little bit higher. Oh, yeah. There's some people who are just really not OK with that and they don't like that. And so if this practice manager turns out to be that rock star, which it sounds like they are based on just the mailbag that we have, they're going to be very motivated to try and change all of those things. And some people are not going to be willing to keep up with that. And so I love that you called so much of that out. I also love the idea of understanding, like, I think for this team, one of the things that I really liked about the mailbag was they said in the beginning of the mailbag that the team has their hearts in the right places.

23:06That they want to do what's best for the patients and the clients. And that's why they focus so much on spectrum of care in general. And this person is trying to bring up the standard a little bit. Yes. And there's been a lot of research that I have loved that people are most successful when they can tie themselves to their future selves. I mean, I think James Clear talks about this in Atomic Habits. It's one of the things that I like. But if I'm trying to eat healthy for myself, it's much easier for me to think about what would healthy Maria choose at this restaurant. Right. Versus me thinking like, oh, what's something healthy on the menu that I can get?

23:37Because now I'm tying it to identity. So yeah, they're technically the same kind of concept. But when I'm thinking about what's a healthy dinner that I could get, I'm tying it to the healthy it being the dinner versus the healthy person being me. I am the healthy person who is making a healthy decision. And so I think when it comes to this clinic, I think there's a lot that can be done thinking about the identity piece and leaning on that. because it's like leaning on the fact that, hey, we do want to do what's best for the clients. We do want to do what's best for the patients. And there's a lot of cool new medicine that allows us to do that.

24:08And being able to bring it from that perspective of like, what are our current clinic's values? If we don't have core values, do we need to build some of those to make sure that this is part of it? But overall, building that identity of we are a high standard clinic. I love that we are a high standard clinic. How do we raise the standard? Do we go to CE? Do we update our protocols? what do we need to be part of that identity that we have? That's also something that from a headspace perspective, just thinking about it, okay, what does a high standard, high quality veterinary clinic look like? And what does this clinic also have that makes that happen?

24:43Yeah, I think you're spot on. Part of the action steps for me, for sure, is building this identity. And I think that for the reasons that you said, I think it's critically important, but we need to get these people to start to see their future selves and where this is going and what's possible. And so I think you're totally right. The one thing I want to mention, too, is when we're talking about sort of changing identity or changing self-belief or self-perception, it takes time. And so I just want to make sure that I'm clear with this. I don't think you can walk in and say you're in or you're out right now today.

25:14It's like we're going to start and this is going to be it's going to be a process. We're asking for a lot of change here. Rome wasn't built in a day. It's going to take some time. And so some people might be on board for a while and then they just go, this is as far as I want to go. And you say, well, I'm sorry, this is partway, but we're going this far again. That's fine. But also you're going to go in and some people are going to be like, I don't like this. And then they're going to stick around and they're going to see what you're doing and they're going to see you start to succeed. And they're going to see the benefits of what you're talking about.

25:44And you're going to get some clinical successes and you're going to start to get some opportunities to work with clients that are interested in doing more with their pets. And they're going to have this sort of higher experience in some ways. And some of them will really love it. They'll think, I didn't think I wanted to do this. And now I just, I really love it. It's more rewarding than what we used to do. And other people are going to go, yeah, I just, I thought I would like this. And I really don't. I want to work at a place that's like how we used to work. And it's like, well, I'll help you try to land a job at one of those places.

26:11I love that you called that out too, because oftentimes we get a lot of people that will be like, how do I change the culture of my practice? And I'm like, just so you know, that takes time. It takes a long time. And this is very similar. You're not changing quite the culture, but you're bringing in a different level of standard of medicine. And I think that that is super smart to think about. And I think also to prioritize as you're going in, because as the practice manager, you're going to go in and you might already feel like, you know, 10, 20 protocols need updating, but you can't do that all at once.

26:38So part of that is going to be prioritizing what changes we do want to push through forward. How do you think they should do that? I think that you're probably changing the culture. There's probably going to be some significant cultures. Yes, yes. You probably are. And if you're not changing the culture, then you're at least stressing it significantly. So you say you've got a good culture and everybody gets along. It's like a challenge course, right? Like a high ropes course. You can take a group of friends and they all like each other. And then you put them on a high ropes course, you know, where they have to like help each other get across a rope bridge.

27:06And suddenly they're going, Maria, why aren't you working harder? And like, you know, they just, it stresses that relationship. I go, at best, you're stressing the relationship. At worst, this is gonna be a radical change in culture. And so I think that that's it. I think there's a couple of things to do. So when we start to talk about making this transformation, I think that there's a few things that you have to lay down and get started with. And this is the beginning of my action steps. Do you want to take a break here before I unpack these or do you want to go into them? Oh yeah, sure. Yeah.

27:34Let's take a break. All right. So let's talk about how we start to make this change. So there's two pieces, like these are big pieces, but there's two pieces for me that are early action steps. My friend, Dr. Dave Nichol, who is a genius, I think the world of this guy, I really enjoy him. He's one of my best friends. He bought a practice years ago. This is back when I first met him. He bought a practice from two sort of, I don't want to say elderly veterinarians, but yeah, they were elderly. One of the two partners had passed away. And the other one was like, I don't want to keep doing this. You know, he was retirement age and everything.

28:08And so Dave goes in and he gets this clinic and everybody's been there a long time. It was a practice that was practicing medicine as the founders had sort of practiced it, you know, over a long period of time. And so the potential for renovation and upgrade were substantial. We'll say that. And the first thing that Dave did, which is absolute genius, is that he went in there and he sent out a thank you sort of commemorative ceremony invitation to all of the pet owners. And so they had this little patch of dirt in front of the vet clinic. And Dave went in there and he turned it into a garden. And then he invited all of the clients to come and say thank you to the departing veterinarian and to remember, you know, the years of his career in service or, you know, all of these things.

28:57And also to dedicate this garden to the veterinarian who had passed away. And it was genius for a couple of reasons. Number one, this is Dave getting to meet all of the clients who were going to be there. And so they come and he introduces himself to, I think it meant a lot to the staff to, you know, for their service to be honored for the years they put in. I thought that that was nice. And he meant it to be very much an appreciation of them and their work. And number three, and this is very important. That's why it's here. Symbolically, this is opening a new chapter. Like this is sending a message that, okay, that phase is over.

29:39And now we're starting the next phase. Yeah. And I think that that type of symbolic, almost like a graduation, if you will, you know, like a graduation, again, bear with me, but like a graduation ceremony, something to do with the people who have been there, something to come in that sends a visible sign and symbol that this chapter is closing and the next chapter is opening. And so that could be something like this. It could be something like a party. It could be something that involves the pet owners. Like a grand reopening. Depending on what this facility looks like, I might very well start.

30:23Are there renovations that we're going to do? Like, bam, let's go. Renovations don't take buy-in, you know, for the most part. Even if it's just a cosmetic thing, we're going to come through, we're going to repaint the inside of the building and put in a new front desk. and then we're going to have a reopening. And again, that might be something that's just internal, but go in there, we repaint the walls, we put the new logo up, something like that, and then we have a meeting. But it's something to say, hey, this is great, but here is sort of the end of the chapter and now we're starting this new thing.

30:57And so I think that that's key. I do have a friend too, I wanna share this idea. I have a friend one time that she did something similar when she first bought her practice, she took over ownership from another clinic. But what she did, she was just like, This clinic might belong to me, but it actually belongs to all of you guys who have been working here for years. So as a result, I would like for us to I'm going to have a day where I have a professional photographer come in and take pictures of you with your pets. So it'll be a day where you just come in with your pets and we'll do portraits.

31:20And then we're going to blow them up on canvases and put them up in the lobby. And so that was something similar that she did where it wasn't it wasn't like a ceremony, but it was very much a hey, this is this is like I want you guys to know that I feel like this is your clinic. And even though I'm the new owner, like it should reflect your faces and your pets faces. And so it's similar to that. But I just wanted to throw that idea out there in case it inspires. I love that. I love that idea. I think what you choose to do is very contextual. It very much depends on what is the situation at this place?

31:51What does it kind of look like? And then it also really depends on what is your vision for it? Where are you trying to go? But I do think that that sort of symbolic transition and you have to pair that up, I I think, with clear messaging about what the next chapter kind of is or is going to look like. And so I really think that it's important when we go into these practices or when we start to engage with the team here, I really want to avoid any sort of negative language or anything that feels critical or judgmental. I don't want to say, guys, you know, there's a lot of opportunities here for us to just do things better than we've been doing.

32:28Guys, I think we can really raise the standards here. I want to avoid those things. What I want to do instead is come in and say, I am so glad to be able to work with you all. I am so glad that this hospital is joining with our hospital. I, you know, the talent that's here, the compassion that I see as I spend time on the floor, you know, and again, it really helps if you know these people, if you've spent some time on the floor, but you know, that type of, you guys have done wonderful things and your reputation is fantastic. And I am thrilled to partner with you so that we can go to the next level and expand the mission that this hospital has had and advance the vision that you all have been working towards.

33:15And again, this is, it's all contextual and kind of where you're trying to go, but it is definitely possible to say to them, we acquired this hospital because, not in spite of the people who are here and the work that we do, but because of the people who are here and the work that they do and the potential that they have to join up with what we're doing. And really, I think that your team can level up in a really meaningful way. And I think that you guys are going to really enjoy the experience. And I think that I can be very clear about change is going to happen. And it's not because you're failing.

33:52This is a great opportunity for you guys. And it's a great opportunity for us. And I'm glad for us to work together on this. And so that's kind of the way I would open up. I would talk a lot about the why. Why did you acquire this practice? What do they do well? What are the values that their clinic and your clinic share or the values of this clinic that you admire? Really lean into that. Like, what is the why of this? Why do you want them to transform? It's not because you're not doing a good job. What is the aspirational why? and then again, focus on that developmental framework. This is going to be a great opportunity for you guys to develop.

34:29I think that we can use the resources of our hospital to come in and work with you guys at this hospital. And really, I think you guys are going to enjoy the evolution that's going to take place here. And I think that there's going to be a lot of opportunity. I think you're going to find this work very rewarding, kind of yada yada in terms around what is the vision that we're building? What is the why behind this development that you want? And so anyway, that's kind of the first two things together, that ceremonial, bookending, clear signal that a change is coming, and then messaging around the why behind the change and the fact that, yes, the change is going to come.

35:03And you guys are great for it, and you are going to be successful, and I hope and think you're going to enjoy where we're going. I love so much of that. I love that that's where you opened it up, honestly, because I do think that that's such a great moment to really just set that expectation of change is coming. Yeah. And then I do think that part of me is going to want to try and do some sort of one-on-ones with the team. Yeah. To dig into a little bit more of what their goals are because this is an excellent opportunity, I think, for me to present myself as like their advocate, their ambassador, somebody who's going to try and make sure that whatever developmental goals they might have had are actually going to happen, especially because sometimes we might be inheriting a practice that maybe the previous practice manager didn't have as much follow-through or the previous practice owner.

35:47So whatever you're kind of stepping into, I think one-on-ones are going to be a really good way to start interviewing the team and hearing what protocols might be their priorities. And if it's their priorities, you're going to get a lot more buy-in on whatever changes you're trying to do anyway. I completely agree. I think I would love the idea of like this that you're describing is such a group ceremonial thing, and then we can still bring it individually to those one-on-ones. I do want to touch on the doctors, though, because I think that that's the harder one for me when I look at this case.

36:15how do you, Andy, help experienced doctors change without making them feel defensive? I think that's a great question. I love your one-on-one idea. I completely agree. My next thing was really try to get by. Let's start to get some buy-in. Who are these people? What motivates them? What are their values? And what ideas did they already have? Just like you said, and this is true with the doctors. That's why I put it here. If I want to upgrade the dentistry that we're doing in this practice, all I need is one doctor who is like, you know, I'd really like to do more dentistry. Like that's, that's my passion.

36:46And I'm like, oh my friend, I want to support you in that. In your dream world, what would you like to do with the dentistry? Where was it like to go? What does leveling up our dentistry look like in your mind? What would you be excited about? And now I'm going to try to recruit this champion inside the practice that likes it. And then I'm going to lean in. And so when you say, how do you get the doctors on board? Number one is you're already on it is who the heck are these people and what motivates them? Are these doctors that are driven by patient care? I can press that button. Are they driven by, they want simplicity?

37:19They're like, I just, you know, I want to be able to get things done. I want to be able to get out for my lunch break on time. I want to wrap up at the end of the day and not have to stay late writing up MEC records. Great. Let's talk about how better systems and innovations that we have at our other hospital are going to help facilitate this for you. Let's talk about how our upskilling of the technicians is going to make that a possibility for you. Are they popularity doctors? Do they want the clients to be happy? It's like, great. Let's talk about the client experience that we're trying to create and what that looks like.

37:51Or are they revenue doctors? Are they like, look, honestly, I'm in a place in my career. I really need to generate money. I'm a young vet and I need to pay off student debts. Or unfortunately, I'm an old vet and I still need to pay off student debts. But like, whatever the thing is, it's like, great. Let's talk about how the changes that we want to make and what we sort of think that that will do for their revenue generation, our ability to, you know, to let them upskill and earn a higher salary or things like that. But talk to them about what they care about. Talk to them about their values. Again, find out what they want to do and then kind of lean into that.

38:20And then the other thing, Marie, is I would go through this process, right, that you and I are talking about of trying to build trust, understand the team, start to do the cosmetic changes, start to, you know, things that don't require buy-in. Like, hey, you know, we're getting new computers in here, first of all. Like, we are upgrading, you know, the infrastructure. Like, Let's go ahead and start knocking that stuff off the list. We're asking for minimal change. And the whole time we're trying to be friendly and supportive and to get to know these people and to build some trust with them and convince them that we really are trying to do right by the pets and the vision we lay out is where we're going.

38:52And then we're going to have to start making changes with the doctors. And so expectation setting I would have for the practice manager is this is a multi-year process. If these guys, if these vets really are, you know, 25 years behind where your other practice is, that's not a 2026 problem. That's not even a 2027 problem. That's like a, hey, let's start to really, first of all, we have to audit where they are. Maybe they're not as far behind as we think they are. Well, we're going to need to do an audit. But we wildly overestimate what we can accomplish in one year. And we wildly underestimate what we can accomplish in 10 years.

39:30Now, this should not take us 10 years. However, it might take us three. So I would break the changes that you want to see in the medicine up into phases because you cannot do everything at once. You cannot overhaul your wellness protocols and your sick pet protocols and your dentistry and your surgery all in the next three months. Like that's bananas. What is the burning problem problem that you, and there's lots of different ways to pick your priorities. And this is a priority setting. Once you kind of understand, look, we are inefficient in surgery and our protocols are not where they need to be.

40:08We are inefficient in dentistry. Our protocols are not where they need to be. We are inefficient in our wellness visits and our technology is not where it needs to be. And our recommendations are out of date. And, you know, the way that we handle sick pets coming in and the way the doctors work up cases, that is also way out of date. Let's just say that those are sort of the four areas. You know, for me, I mean, it really depends on what I need. If I'm like, oh, crap, this was a big spend and we have significant revenue pain, I'm going to look at those four things and saying, which of these areas, if we get it in place, is going to help us generate revenue so that we can reduce the revenue pain while we work on the other areas.

40:47You know, do I have technicians that are saying to me, we want to do different things. We want to be more advanced. We want to use better protocols in our wellness visits. I'm like, but if I got motivated champions, if I don't update my wellness protocols, then there's a chance that they're going to lose trust in me. And we've seen that. I've seen plenty of practices where they're like, we're going to make these changes and everyone's excited. And then a year later, none of the changes have been made. And I don't think that those people are lied to. I just think that the leadership never got to it.

41:18And those people start leaving because they're like, I don't believe it's going to happen. Yeah, nothing's ever going to change. Nothing's going to change. And then you've got a whole other re-motivation campaign. So a lot of it is, again, is contextual. What will the team be excited about? Because that will give you some motivation. What do you need from a revenue standpoint? Like that may change those things. What stacks? And so, for example, addressing surgery often, I mean, it's going to involve our dentistry protocols, our drop-off protocols. We're already halfway through upskilling our dentistry phase.

41:49And so, you know, if we do surgery, that may push us pretty far on dentistry. Do we want to then immediately go to dentistry? Or do we want to do surgery, solidify our groundwork while we work on wellness, let that sink in and then come back? And again, there's not a right or wrong way. It really depends on what is the appetite of the team? What are the finances? What are the opportunities that you sort of see? Your return on investment? Where are your client pain points? If they're like, dude, you know, we can't get an appointment. We can't get in here. and the communication is awful, that might be the change that needs to go first.

42:23But anyway, I think where people get overwhelmed is they're like, we're going to fix everything at once, go. And I would say, I would do this in phases. I would break up your phases and you can even message what your phases are going to be. And then I would focus on your protocols, on your training and your education, on your pricing and your implementation strategies. and I would really do that. And I would make whatever phase you pick, I would lean hard on it because you want it to work and be successful. And then if you can pull that off, then people tend to believe that you're probably going to be successful in the next phase.

42:57You know what I mean? And you can get a win that you can build on. And so anyway, also the idea, again, in picking our phases, sometimes picking a phase that you think is most likely to go well, sometimes that's the right call because it lets you get a win under your belt and convince people that change is really going to happen and makes people feel like they're making forward progress before you roll into the thing like, hey, guys, we need to talk about how we're working up sick pets that are coming in the door. Because that's way more complicated than saying, hey, we're going to talk about our anesthesia and our drop-offs.

43:27Well, it sounds like one of the priorities for this practice manager was the whole spectrum of care thing. And that might have been driven from revenue, like maybe she's trying to bring up the revenue of this practice, and noticing that we're not always recommending gold standard. So in the spectrum of care case where we're talking about not necessarily changing the quality of medicine, but rather the recommendation, making sure that it is meeting the gold standard still and giving them that option. How do you even have that conversation with doctors? Around recommending gold standard? Yeah. I think that's a fairly easy conversation to have because what can happen is I can come in.

44:04And the nice thing in this regard is you can talk to all of the doctors without singling anybody out. And you can also talk to them and act like this is not right or wrong, good or bad. This is what we do at the other hospital, and we want to bring that over here. And so I expect you guys to continue to work with the clients as you have been, and access to care is important to us. And also, it is important that we start to make and document recommendations of what we consider to be the gold standard of care. And so let me give you guys a couple of examples of what we're looking for and talking about when we say offering the gold standard of care.

44:42And then I would I would have a couple of examples together of different cases. And honestly, I think you have you've got to. Yeah, because otherwise. Yeah. The thing that bugs me about spectrum of care and this does bug me, it doesn't it doesn't mean anything. Like, you know, and everybody thinks it means something. I mean, no, it doesn't even mean anything. If you talk to people in the UK, they're like, do you mean contextualized care? Because that's what they call it. And honestly, that's a better name. Yeah, I do like that name better. It's better. But it's like you say spectrum of care to one person and they're like, oh, I'm imagining well-documented tiers of service.

45:20And you say to somebody else and they're like, I've been doing spectrum of care my whole life. It's like, what can you afford? That's what we're doing. This is what we'd like to do and this is what you can't afford. You tell me how much money you have and I will spectrum of care us a plan that fits in that one hundred and thirty seven dollars and like lumping the things together like that. I think and again, don't get me wrong that I'm crapping on the concept. It's just that language. I think people immediately tell themselves a story about what it means. They all have different ideas of what it looks like.

45:51Some people are like, we've been doing this forever. Other people like we've never done this. and you're like, this requires far more research and documentation than we've ever had. Like, it's just kind of bananas and nobody aligns on it. Tell them what you want. Don't even use the term spectrum of care. Just go in and say, it's important to us that the clients are given options and we always wanna make sure that we can document that we gave them the highest standard of care option. And so I'm gonna give you guys three cases. I want you guys to come up with, as just work as a group you guys tell me give me the best gold standard option that you come up it doesn't like money is no object what would you what would you recommend and then I'm gonna tell you what I so what I have on my list or what you know the doctors at the other clinic kind of what they put together or what was recommended to one of our previous patients you know at the other clinic so you guys can see I don't say I really like I like that but then you can let them say all right well if I had to give you the gold standard I'd recommend, you know, this and referral and whatever, you know.

46:53But then you're doing it with them and you're letting them work on it, but you're showing them this is what our recommendations are going to look like going forward. And so I'm not asking you guys to practice differently. I want you guys to make sure that you are making this style of recommendation, things like that. And then I would also let the, I said, I'm going to let the technicians know that, you know, that this is what's going to happen as well. And then I would talk to the techs. And I guess that's my last thing and getting the doctors done if you want to get doctor change one of the big things is talk to them reason with them understand what their motivators are lean into the why and then use your text as a backstop you'd be like hey i'm gonna i'm gonna talk to the techs they're gonna be asking you about a gold standard invoice or a gold standard estimate and you know and that's what they mean and so don't please don't give them a hard time if they ask you for a gold standard estimate they're just trying to remind hey should we talk about this and you can decline that if you want, but we're going to talk to them as well about presenting estimates and providing multiple options.

47:53And then that way, you've got multiple touch points. You've got the text to apply some pressure to the doctors, the doctors hopefully to apply some pressure to the text. And then everybody's kind of leaning in together. And it's not that, hey, I'm going to talk to the doctors and then we're going to stand back and hope that they do the changes that we asked them to do in a vortex. Like, no, it's sort of that old trust, but verify. It's like, I trust you guys will make these changes. and also we're going to have the technicians train to help support this change. So that's kind of how it looks at.

48:23I love all of that. Well, thank you so much. Is there any other final thoughts on this? I think that that's it for me. Oh, the last part too, as I put this together, at the very beginning, so you're sort of figuring out your phases and you're starting to work with the doctors, one of the first things that I would get into place is your key performance indicators or your metrics and I would get your accountability system set up. And so what this looks like is, how are you going to define success for this clinic? Don't wait until you've wrestled with these guys for a year before you figure out what is success for you.

48:58Go ahead at the very beginning and start to say, hey, this is kind of what we're looking at. These are the metrics that we need. My advice to you is to not pick financial metrics or at least not exclusively financial metrics. They don't want to hear that you've acquired their hospital and you've got money goals. I think that having targets around the, and again, I would do an audit of the hospital. And then what are your diagnostic numbers look like? What are your dentistry numbers looking like? What are your wellness blood work numbers looking like? Like, what are your compliance numbers? Go ahead and start to build some medical quality metrics and name them early because that sends a message about what you care about.

49:38But it can be a shared language. People can know kind of what you're working on and why you're working on it. Anyway, I would pick those metrics. And then I would go ahead to your point, I think getting the one-on-one started and starting to have some accountability conversations just around like checking in and, hey, you know, these are the metrics we talked about last time. How do you feel it's going? You know, hey, I've noticed that your client numbers have gone down actually since, you know, two months ago. What's going on? How do you, like, what happened there? What are your thoughts on that?

50:06And just start to let people know, not a big deal, but let them know, like, I'm serious about this stuff. We're going to be, I'm going to be asking you about it. And so it's just gonna be easier on everybody if you kind of get on board. But go ahead and start that. Start sending that message to like, I'm going to ask you about this. You're not going to be able just to quietly opt out of the change that we're making. I love that. And as always, praising the behavior we want to see. Exactly. People learn so much through story. They love sharing. I noticed one thing that popped in my practice when we were doing dentistry, we would follow up like a couple weeks later.

50:37And that's usually when the client was like gushing over, oh, like, you know, he's kissing me again and I don't hate his breath. Oh, he's not hiding under the bed anymore. But all of those things and the technicians would share in the team meetings. But then that would motivate us to like, wow, what a great thing that we found those, you know, extractions that needed to come out because now this is the result. But they only hear those success stories if they're doing those follow ups two weeks later and actually talking to the client about the success. And so sometimes it's as easy as like, are we celebrating those wins?

51:07Are we talking with the clients about how we move the needle? If we didn't do dental radiographs before and you're bringing that in, we need to show the impact of those dental radiographs, whatever you're doing. So you nailed it. It's positive reinforcement. As you said, it's appreciation for people who are putting forward the effort. And then it's really an internal public relations campaign. And Maria, like you're amazing at that. But just sort of saying, hey, I want people to feel the love and to feel that this is going well and that we're doing good work. And so I'm going to message it. It's going to be in our Slack.

51:38It's going to be in our meetings. It's going to be, you know, on our website. It's going to be on our Google reviews, which we're going to share internally. But we're going to run a PR campaign for the good that these changes are making. Anyway, I think that's fantastic. I love it. I love it. It's been great. Thanks so much. Thank you. And that's it. That's what we got. Thank you guys so much for listening. Thank you for sticking in there with us. I know that this is a tough one because we want to support the team. We want to improve medicine and we have to slow down in order to do that. For somebody like me, who's somewhat impatient, that is a hard thing to do.

52:12But I think this is still such a great problem and coming from such a great compassion. You believe that Uncharted is turning 10? That's right. Uncharted Vet Here Conference is celebrating 10 years and you're going to want to be there. It is happening on January 15th, 2027 and registration is open right now. Uncharted Vet dot com. Hope to see you there. Passionate spot. So I love this mailbag. I had so much fun. Thank you to Andy for joining me. Thank you to you guys for listening. Thank you to everybody online that is watching. And as always, if you like this episode or any of our other episodes, please leave us a review wherever you listen to your podcast.

52:45We love to hear from you. Thank you. And we'll catch you next time.

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