Dr. Josh Rosen - Clinical Empathy and Communication.

In this episode, Dr. Cliff Redford interviews Dr. Josh Rosen, who specializes in clinical empathy within veterinary medicine. They discuss the importance of effective communication with pet parents, the challenges of empathy in a high-stress environment, and the impact of compassion fatigue and burnout on veterinary professionals. Dr. Rosen shares insights on building trust with clients, the significance of understanding the human-animal bond, and the rewarding experiences of volunteering in veterinary care. The conversation emphasizes the need for empathy and connection in veterinary practice to enhance both pet care and professional fulfillment.

Follow Dr. Josh on Instagram, at @dogtorjosh

First, if you haven't watched my film and live in Canada (or have one of those VPN things), you can watch it here:

https://youtu.be/oMUx3yuyznc?si=oagpg7bGnpbuyXlJ

Be sure to follow me on Instagram @drcliffworldwidevet.com and on Twitter at @drcliff_vet
Listener questions, episode suggestions, or if you have a good idea for a guest, email me at dr.redford@vet905.com
Additional information can be found at drcliff.ca

Transcript

Dr. Cliff Redford (00:00)
Hey everyone. Welcome to another episode of vet life. On this episode, we got another great interview. I'm knocking them out of the park these days. At least I'm really enjoying it I'm really excited. Dr. Josh Rosen is going to be joining me and I got intrigued about meeting him. We sort of follow each other on Instagram. We got some mutual friends. ⁓ I believe he did the volunteer trip in Costa Rica with Joffrey.

the technician at ain't doing right. Uh, that was on the podcast a couple of weeks ago. Um, but what really got me interested was he specializes or has a, uh, a special interest in communicating properly with pet parents as well as clinical empathy, which what exactly is that? Uh, we're going to find out. stay tuned for Dr. Josh Rosen.

Dr. Cliff Redford (01:06)
Hey everyone, welcome back. And as promised, Dr. Josh Rosen is in the house. How you doing, man?

Josh Rosen (01:13)
I'm doing great, doing great. So happy to be here. Thanks for having me.

Dr. Cliff Redford (01:16)
Yeah, yeah, my pleasure. No, I'm looking forward to this. So as I had mentioned in the intro that you were not a part of, you and I have some mutual friends on Instagram. Instagram told me to follow you, et cetera, et cetera. Sometimes the social media is cool. And then I noted on your profile that I guess you have a special interest in clinical empathy, which I didn't know what that was.

Josh Rosen (01:31)
Love that.

Sometimes.

That's right.

I'm happy to help you walk through it. ⁓ So, yeah. So I'm really, really passionate about clinical empathy. I've been in veterinary medicine for about seven years now, about two years in relief medicine. About three years ago, I was working as a medical director and I was kind of assessing through... ⁓

Dr. Cliff Redford (01:48)
Yeah, so tell me, tell me what is it?

Josh Rosen (02:08)
different associates that I was working with in regards to how can we help them in the exam rooms? How can we help them with communication? What are differences that I'm noticing in regards to ⁓ difficulties that different veterinarians have in regards to getting people to agree with their recommendations in regards to sick cases or even just wellness cases? And I recognized very quickly that it doesn't

Communication is difficult and we don't necessarily learn a lot about it in vet school and part of that is because it really requires practice and it's very difficult to create settings where you can truly practice those skills on a day-to-day basis in an educational setting. ⁓ I recognize that there's a benefit to...

seeing a pet parent in a situation that doesn't just involve what's going on with their pet, but what's actually happening to them too. Being able to identify and observe the pet parent's perspective is really step one with clinical empathy. And the benefit of doing so is not just being able to see, you walk into a room, ⁓ say a pet is coughing, that's their initial complaint, you've already got a brief history from your assistant. ⁓

You want to go in and know what you're going to recommend. You're going to want to know what you're looking for on your exam, what you're ⁓ expecting based on their signalment, their age. But before you even get into any of that with that pet parent, you should also know that maybe that dog has been coughing all night. And that might be the reason why they brought that dog in. And why is that important? Well, if you show the pet parent that you care about their perspective just as much as you care about making their pet feel better,

you're going to end up in a scenario where you truly are able to one, get their pet feeling better, but also let the pet parent leave feeling satisfied with everything that happened that day. Because yes, it is a baseline that a pet parent is going to care about what's going on with their pet. But if they're coming in on a Monday at 10 a.m., you can probably guarantee that they are missing some form of work or something important in order to bring their pet in. And they love seeing you. Don't get me wrong, but

you know, life happens real, real, you know, difficult schedules and day to day or work life or managing kids. ⁓ It truly is more complex than us just fixing their pets problem in a given moment. So observing that pet parents perspective, and then being able to basically put yourself in their shoes and say, Well, how would I feel if I was in this situation? And how can I relate that to

getting their pet to feel better. thinking about that coughing dog, if that dog's been coughing all night and the pet parents barely gotten any sleep, ⁓ they probably are gonna vent to you about it in the intake and maybe your assistant will have given you a little bit of a clue as to that being part of it, but they'll probably continue and let you know when you go in and you paraphrase what they're presenting for. ⁓ Being able to take 30 to 40 seconds to just be able to say, yeah, that.

That sucks, man. I definitely hate it when I don't get a good night's sleep, especially combining it with having to worry about what might be wrong with my dog. Let's talk about some options to get them feeling better. Let's talk about some options to try to find out what's going wrong if we want to go that route. And you'll find that people are so much more ⁓ in tune with what you have to recommend because they don't just feel like another number. They feel like you both are people on the same mission to help them out.

Dr. Cliff Redford (05:43)
Yeah. Yeah. Too often, or at least I remember, I don't hear it as much anymore, but probably because I'm not in school and I'm not, you know, sort of having the same communications. But I remember being in school way back in the late nineties when so many of my classmates would say, well, I got into veterinary medicine because I love medicine. love science. I love animals and I don't like people. And surprise, surprise the animals don't talk.

⁓ even though sometimes we can communicate with them, ⁓ you know, and they've got a human attached to that leash or carrying that, that, that carrier. And I definitely see a difference. mean, there's, there are wonderful, technically skilled, ⁓ veterinarians out there, but they don't have that sort of communication factor and they're not able to utilize their skills to help out the animal as much because they can't.

sort of empathize with the pet parent.

Josh Rosen (06:46)
That's right, or at least it's very difficult for them. I think that the empathy definitely comes very easily to some people than for others. But what I also really like to talk about in regards to veterinary medicine specifically is that no one gets into this field without passion. Nobody gets into this field without the passion for animals. And if you care about animals, you have compassion. There's no

Dr. Cliff Redford (07:05)
Mm-hmm.

Josh Rosen (07:11)
world where you can care about how animals are doing, beings that have no ability to communicate with us and feel that they have an important and a right to feel better and to live longer ⁓ without having that passion and empathy. So how do we connect the dots in regards to that, knowing that the passion is there? Well, we need to lean into the idea that

We are also responsible for that human animal bond, right? The idea that we're just there to help the pets feel better. It would be great if that's all we had to manage. It certainly would make our lives a bit easier, but it's just not real life. part of our oath is indeed looking out for that human animal bond because we know how important that is for pets to receive the care that they need.

Dr. Cliff Redford (07:39)
Mm-hmm.

Josh Rosen (07:59)
you know, every, I shouldn't say everyone, but we know for the most part, people that work in vet med have had a pet at some point in their lifetime or be able to experience what it's like to have a pet that is sick and that's not doing well. And you don't necessarily have to, ⁓ you don't have to align on every aspect of care with the person. You don't have to agree with them on everything that's going on, but you can always rely on the, on the idea that you both want.

what's best for that pet. And it may be from a different lens, but being able to focus on that is truly what helps both of us meet halfway. Because the more that the client thinks that we're only there for the animal, ⁓ the less they're going to feel comfortable letting us know what's going on in the day to day of that pet. They might be more likely to feel judged, ⁓ to feel that they don't. ⁓

you know, that they can't trust, you know, the people that are truly there to support them. ⁓ I used to say, if you feel that vet med is for you, because you hate people and you love animals, it's probably not for you. I don't really like saying that anymore. Because again, I do believe that empathy is a learned skill that you can tap into. And if you are passionate about vet med, you already have that, ⁓ you're already 50 % there, right? So ⁓ I think that we've all

been in that mindset at some point in time, we've all had a really bad day like, man, I really wish this pet didn't come attached to their human today, but we don't get that choice. And to be honest with you, the person is the only avenue we have to find out what's truly going on with that pet, right? Imagine practicing without a history every day. That's crazy.

Dr. Cliff Redford (09:44)
Yeah, yeah, no, absolutely. And I mean, we, uh, at least here in Canada, I don't know. I can't remember. I'm going to assume the lockdown, the COVID lockdown was similar. You're in New York, right? Yeah. So it was probably similar for you, but you know, there was the joke that for 18 months we got to basically just focus on the animal and people weren't allowed in the clinic and my clinic's big enough and has space that, that, you know, we could have, we could house multiple patients.

it's like, okay, drop fluffy off at the door, go back to the car. We'll give you a call. Bump, bump, bump, bump. I quickly realized how fast I could do a physical exam when the chit chat wasn't there, but I also missed the chit chat. Like I ended up, I missed, I missed some of that connection with people and, seeing the kids grow up and you know, ⁓ some of them are now adults and they have kids and.

Josh Rosen (10:25)
Client's not there. Yeah. Right. Right.

Dr. Cliff Redford (10:40)
And all these, you know, the human-human bond was something that I missed as well. But yeah, it became more difficult to treat the animals ⁓ without having that human right there in the room where you have to keep bouncing via phone back and forth these questions. So ⁓ as much as...

Josh Rosen (11:01)
And you don't get

any non-verbal communication is out the window, right? You have no idea what's going on with them and how they're receiving the information that you give them. It's just a matter of, you know, very linear bilateral, here's what I want to do. Let me know if you want to do it. And hopefully they already trust you, right? Because it's so hard to build trust over the phone.

Dr. Cliff Redford (11:20)
Yeah, yeah, no, absolutely. ⁓ And I love my clients. I love meeting them. I love talking to them. ⁓ Of course, there's varying degrees and there are some that I get stressed with and we don't see eye to eye. Look, there's some patients that don't see eye to eye with me either. I mean, that happens and it's nobody's fault. ⁓

Like what can we do? You say empathy is learned, which it is. mean, I think there's a like athleticism, there's an innate skill, and then you can become more athletic by training and eating your Wheaties and those sorts of things. What can we do as a profession? And this isn't just for veterinarians, but what can we do to become more empathetic towards our pet owners?

Josh Rosen (12:14)
That's a really great question, a really loaded question. ⁓ I think that from a rational lens or a logical lens, which we all really like to look through in regards to learning new skills. ⁓

being able to go through every scenario in your mind, whether it's retrospectively looking at something that happened or actually in the moment trying to think it through before you walk into that room, that you are trying to identify pet parent pain points. And when you identify those, you're utilizing those in conversation throughout that consult, given, again, we're not talking more than 8 to 12 minutes that you're in that exam room. ⁓

but you're able to create ⁓ empathy statements. ⁓ The idea that you're creating phrases or you're deciding what to say based on what you know their pain points to be. It's a very broad way to look at it. An example, we talked about the coughing dog before, that's an easy one. But the other part of this is knowing what helps to build connections. So something that I really rely on a lot and I talk about a lot is the idea of using people's names.

Cliff, everyone out there likes to hear their own name. It's a natural reward center that gets hit in your brain when you hear your name. so naturally, when you go into a room, given if you already know each other, you've known each other for a while, there's not really a need for big introductions, but you should still certainly use their name and reinforce that they do have that connection with you. ⁓ I'm a relief vet. So probably 70 % of the time I'm meeting a new person when I'm going into that consult.

I spend a good three to four minutes introducing myself, making sure that I shake hands with each person in there as long as they're comfortable with that. And ⁓ honestly, even saying to them like, what's your name after I introduced myself, because a lot of times they are very nervous to be there. They're very focused on like maybe even in the moment that I walk in, they're already putting their pet on the table because they're just so nervous to find out what's up with their dog or what we're gonna do about it.

But being able to take a step back and take a breath and say, no, I see you here. And you are another person. And I'm a human being too. And we're all going to try to figure this out together. ⁓ I've definitely worked in settings where there's high volume. seeing 20 to 25, maybe even 30 cases a day. Those moments, ⁓ they only increase in importance when you have less time with the client.

When the less time that you have, the more important it is that you try to build that connection or reinforce it. So saying people's names is huge for me. think that it was one thing for me ⁓ starting off that it was something I always wanted to try to do in that exam room is say the client's name two to three times. And it was noticeable to me that when I did that and when I forgot to do it, I was going to have a little bit more of a difficult time.

⁓ Difficult is not really the right word to use, but just to say that maybe I felt like I could have done better in that communication after leaving because it took longer to get to the yes or maybe even they needed to take a day or two to think about my recommendations. I always think back to say, well, is it something that I did or is it truly that they just needed more time? You may never know. ⁓ But being able to say the name, I absolutely see a difference in building that connection.

⁓ Sign posting is another thing I lean on a lot. The idea that you're basically building a roadmap for that client. ⁓ These are things that are not always verbal, but being able to set expectations is huge because a client comes in, they don't know that your appointment with them is only 20 minutes. They don't get to see that schedule that you're staring at all day. ⁓ They don't know that you're only planning on being in there for eight to 12 minutes.

being able to walk in and say, hey, I know this is going on with Fluffy. We have x, y, concerns. ⁓ I want to take the next five to six minutes to talk about this concern because I think it's the most important. And then let's chat about any questions that you have. If we need to address something else, we'll talk about it as well. But I'd like us to split this up into a follow up and maybe a week from now and break them out into problems we can solve together. ⁓

And being able to walk in with that energy to say, I'm going to lay out for you how this is going to go. Even if you've been here a thousand times before, it just sets the stage that you are the authority in the room, which does build trust. It's not a bad thing to have authority when you are the person with the information that they're coming to consult with. That is part of being able to trust that doctor. If you went to the doctor yourself and you felt like they weren't very confident or they were a little bit wishy washy about how they wanted to proceed with things.

you will naturally feel a little bit hesitant to trust because you want the confidence in their recommendations, right? You want to feel like you don't have to question what it is that they're recommending.

Dr. Cliff Redford (17:10)
Yeah. And it's not only trust in, I can trust what Josh is telling me. ⁓ therefore he's not trying to rip me off or something, but also trust in your abilities, you know, like people are stressed. People were constantly told by, ⁓ you know, experts and rightfully so that, you know, a space surgery is not just a space surgery to the average pet owner. Like to them, it's surgery.

Josh Rosen (17:21)
Yes.

Dr. Cliff Redford (17:38)
And to us, yes, it's routine and we've done thousands of them, but it's still a major surgery. And even if it isn't a major surgery, these, these, these people are, are, are handing over their beloved pet to us for the afternoon. Waiting on that phone call. When is this, when am I going to get the phone call that everything's okay? ⁓ so it's important to them that they, they trust you morally, but they also trust in your competence and.

Sometimes just, you know, we'll say, you know, we're gonna take Fluffy to the treatment area. We've gotten used to recently not saying the back room. We're gonna take Fluffy to the treatment area and grab some blood and this and that. ⁓ And then I'll just say to them, look, I know this is a stressful time. Everything's gonna be okay. Now I'll only say that if I know everything's gonna be okay. ⁓ You know, if I'm not sure, then I might say Fluffy's in good hands.

Josh Rosen (18:28)
Sure. But even just saying.

Dr. Cliff Redford (18:34)
We're gonna be speaking regularly, that sort of thing. that trust in both morality and competence is so key to keeping them relaxed and helping the animal get the care that they need.

Josh Rosen (18:51)
Absolutely. I think that, ⁓ you know, something that commonly I'll get a little bit of feedback about is the idea that like, well, you can't just always be nice to clients. Sometimes you have to give bad news and it's like, yeah, I mean, I understand the perspective that you're coming from in regards to that. I think that it's just a misunderstanding of the situation to say when there's a negative prognosis, ⁓ a poor or even grave prognosis, I'm not going to ⁓

make that look better than it is, right? ⁓ To say, I want them to feel supported. That is the most important aspect of care at that point in time, if the prognosis isn't looking well, that you're not only going to do your best, but you're going to support the clients every step of the way. And they're not

Dr. Cliff Redford (19:21)
Mm-hmm.

Josh Rosen (19:39)
Don't get me wrong. Everybody wants to hear that their pet is going to be OK in those situations. But if you've already walked through what's going on with their pet, we're not talking that this is the first thing that you say. You've already explained why the prognosis is poor, that you are then focusing on how they need your help, because that's what your role is in that situation. It's not a matter of being nice to them because the prognosis is poor or being extra kind. It's truly just doing your job when that situation arises, right?

You can't just look at a situation and go, well, that prognosis is poor. So good luck. Like, you obviously need to fill that gap there. And sometimes it's hard to do. ⁓ It's certainly not an easy conversation to have. Most of compassionate communication is not easy. It takes time. It takes practice. It takes making mistakes and being comfortable with making mistakes. Because it's all about communication. It's all about being able to identify how your communication style

is landing with that that pet parent, right? ⁓ You mentioned before, you know, routine spays for pet parents are not routine spays unless they've had five dogs in their lifetime, right? Like this could be the first time that they've ever had to do a major abdominal surgery on their pet. And it's straightforward, simple to you. But I'll tell you firsthand that I have had days where I'm really exhausted and I pick up the phone and call a pet parent and update them on their on their pet's spay. And I just say,

Hey, this is Dr. Rosen. I just wanted to call and let you know that Fluffy's spay was routine. No complications. You can come and pick up at 2 o'clock versus days where I'm on my game and I'm like, hey, I just wanted to give you an update. Fluffy did amazing for their spay today. It was absolutely routine. No issues at all on my end. They're recovering now. We're just monitoring for pain. So we'll just keep an eye on them for a little bit longer. We have some discharge instructions for you that we're going to go over when you get here. But I want you to hear from me.

That cone, super, super important. Please keep it on at all times. We'll go over that again when you pick up later. ⁓ The energy matters. And that's what they're looking for, right? And it's to say, I get it. We're tired. We do not work in an easy field. We do not work in a field where we get to leave at 5 o'clock every single day and have tons of time to relax at home. There are weeks where it's very rough. ⁓ But I will also say,

We make our jobs more difficult for ourselves when we turn off the empathy because of how exhausted we are. We leave work with less fulfillment and we have more client issues, more conflicts that develop because we feel like we're too tired to empathize. The reality is is that it's harder when you're tired. Don't get me wrong, but you will still leave more fulfilled when you lean into it, even when you're tired. You will have less.

client issues where you're going back and forth on the phone because they thought that you said that you should do one thing and now you're doing the next. Well, if you had ⁓ approached it with the idea that you're looking at things from their perspective, you're going to make sure that your conversation is crystal clear and that there's no opportunity for miscommunication. ⁓ That doesn't mean that you're going to be perfect. That doesn't mean you're not going to make mistakes, but it's the lens that you choose to look through when you're in these situations.

Dr. Cliff Redford (22:55)
a great way of putting it. And yeah, like the exhaustion that we feel is rarely ⁓ due to physical, right? Like, yes, we're standing, but we're not running a marathon. I'm an endurance athlete and quite a skilled one. I get exhausted and it's because of stress. It's because of focus. It made me not even be stressed. Like I love bladder surgeries.

I absolutely adore removing bladder stones. ⁓ I don't want your dog or cat to get bladder stones, but if they do, I want to be the one to remove them. But if I do a couple of those in a day, I'm exhausted because I've focused so much. Well, if it's emotional sort of stress that's causing physical exhaustion, then try and grasp and enjoy those connections that you have with people and that stress will be reduced.

Josh Rosen (23:48)
That's right.

Dr. Cliff Redford (23:52)
and then you'll start to feel a little bit better. ⁓ You know, this is a pretty decent segue into something you posted and I don't know if it was something you came up with or someone else's quote, but it was absolutely brilliant. I've talked a lot about burnout in this ⁓ industry and how I am blessed and too blessed to be stressed. I am blessed that I have not really felt burnout. I've been a veterinarian for 27 years, no compassion fatigue.

⁓ you know, there might be a day where I feel burned out and I know how to deal with it, but I joke that I am one of the few people I seem to enjoy owning a clinic and managing my team and seeing clients and sometimes working mostly working six days a week. And you wrote that a feeling of fulfillment is a shield against burnout. And it, after 27 years, I finally figured it out why I don't get burned out.

or feeling that way because of the immense fulfillment I get from my job. Like, how did you come up with that?

Josh Rosen (25:00)
So I will say right out front, I did not make that up. ⁓ There are many studies in human medicine. ⁓ There's two or three that are in vet med that probably came out in the last five years. Two of them are in JAVMA. I can definitely send you them after, but it's just the idea of what we've done to research burnout and compassion fatigue, right? The idea that this is not something that is, ⁓ what causes burnout? It's A.

And sometimes it's maximized by B. Like there are so many different things that lead to burnout and compassion fatigue in our field that you can't just say, we'll just do this one thing. What we can see is that there are many that work in this field, just like you described, don't always, or to say that never or rarely get those feelings of burnout. And where does that come from?

It's the idea that you are working in an environment where you are constantly feeling rewarded for what you do. And that's part of what can make VetMed somewhat addictive as well. The idea that, you know, well, this is where I get my value from. That's kind of a different conversation. But the idea that when we're truly leaning into ⁓ being able to accomplish the goals that we want to for our patients, for our clients, building the connections that we want to have naturally as human beings,

We will leave work feeling fulfilled. I definitely have gone through some roller coasters in the past seven years. And I will tell you that the moments that I feel the most compassion fatigue, the most burnout is when I'm not getting fulfillment out of my job. And that typically is what ends up leading to ⁓ a somewhat of a career shift, right? To say, where am I going to get that fulfillment from? Sometimes it's a bit of ⁓ a journey in figuring that out for yourself. But the biggest thing

is being able to look at your job every day and say, do I get out of this? Because this is taking up a ton of my energy. It's not physical, but it's still a ton of my energy. And that means that I have to be very willing to understand that this is something I truly want to do. And then I'm truly getting something out of. Again, every single person that goes to vet school, that graduates, that becomes a vet, that passion for animals is undeniable.

How do we use that passion and focus our lenses on the positive impacts that we're making on a day-to-day basis and also try our best to limit how much negativity we are truly taking on and burdening ourselves with on a day-to-day? Some of that's going to be out of your control. When you're in situations that create moral distress more often, you're definitely not going to get as much fulfillment out of what you're doing. And that's why

support and a team and ⁓ you know, ⁓ is extremely valuable in this field. ⁓ But it also starts with the individual. It starts with being able to see, well, I wanted to be in this field. So what am I truly getting out of this? When I get home every day, do I look at my dog and I dread that? crap, what are you going to, you know, ⁓ get sick with with for me now? Or what did you eat out of the garbage can and you're just gonna

build that negativity, burden it with yourself every single day. Are you gonna come home from work and be super happy to see your dog after a long day of helping all of these different pets? ⁓ It's not straightforward. But the thing that I do relate to the most that I certainly also did not invent is this idea that we talk about compassion fatigue and compassion fatigue is a real term. I just feel that it's a huge misnomer because

often we hear that word and we think, well, compassion is causing the fatigue. And it's like, no, the it's like a syndrome. It's defining what is happening, right? It's to say you're fatigued of compassion because of other things. But we are we are people, we are humans that that don't want a long way to a solution. We want shortcuts. We want to feel like there's an easy way to be able to avoid that that heavy feeling that we get when we start feeling the compassion fatigue.

I promise, I promise it is not disconnection. It is not dissociation. It is not removing yourself from that connection with the pet parent. Leaning into that will only lead to cynicism and further ⁓ negativity or even disliking of your profession. And that can really get in your way. What almost ⁓

treats it is compassion, is saying, this is a moment where I can be compassionate for this individual. This is a moment where I can take an extra four minutes to explain this in a different way because this person seems really confused, really worried about their pet. This is a moment where I can sit with a client in the lobby because they're crying and they don't know what's going to happen with their pet. ⁓ This isn't just the doctors. This is your entire team, right? This is everyone leaning in with the same message, the same purpose.

Dr. Cliff Redford (29:48)
Hmm.

Josh Rosen (30:14)
And when you think about compassion and where compassion leads, it leads to fulfillment. And it truly is the case that fulfillment protects burnout. ⁓ I want to shout it from the rooftops to get that message across because I don't think enough of us really focus on why we receive fulfillment from this field. We focus on how many pets we can help in a day, which isn't wrong. It's just to say that you may not get fulfillment out of that number.

Dr. Cliff Redford (30:41)
Yeah. Yeah. One of the things I have found myself doing over the last maybe 15 years, I've owned my clinic for 26 ish years now is, now it's, now it's, like habit. don't even go through the process, but I would formally at the end of every single day, sort of review in my head as I'm driving home, all the patients I saw and recognize that 99 % of them left in a better way than when they arrived.

Maybe they just got protected against communicable diseases. Maybe, you know, for that bladder surgery, I got to take out those painful stones and, you know, we're going to be able to analyze them and find out how we can avoid it. Or maybe we had to say goodbye to a pet and take away their pain. But all of them were, you know, left in a better situation. Even the ones, you know, we had an urgent case come in.

recently, non-client. you know, unfortunately the dog was, the prognosis was very, very horrible. I won't get into the medical side of it. ⁓ And for various reasons, they elected, they wanted to take him home and have him pass away on his own. ⁓ And we were not able to talk them into euthanasia, which sounds so strange, but I was still able to give him some pain medication.

Okay, we're going to give him some pain medication and you know, I'm sort of joking to myself that at least he's going to see pink, pink elephants flying around in the sky ⁓ as he passes away. ⁓ and you know, it's not the ideal ending. I wanted to try and help them. ⁓ prognosis was poor. So if they weren't able to proceed with that, I wanted to at least help them towards that rainbow bridge peacefully. But that doesn't mean you just throw your hands up and say, okay, well then I can't help you, right? You gotta, you gotta do your best. So.

Josh Rosen (32:35)
Right. Yes.

Dr. Cliff Redford (32:40)
recognizing the positive impact we have, even in when the cases don't go the way we want or we don't get the pet parents that we think we deserve or we think the pet deserves. We're still able to help that pet and help that parent, that family out. And it's a great way of sort of avoiding that compassion fatigue or burnout. The other thing you said was avoiding the negative or not focusing on the negative.

I get flack from a lot of people for this. I don't read Google reviews. I don't read negative Google reviews. I don't respond to negative Google reviews. Now I also don't read positive Google reviews and there's a lot more positives than negatives. I completely ignore it because I have never seen it work, you know, ⁓ or, know, the one in a hundred times it works. That's a pretty bad prognosis that is going to work. So I would rather focus on.

Josh Rosen (33:34)
Bwahahah

Dr. Cliff Redford (33:37)
⁓ the people that aren't keyboard warriors. ⁓ so yeah, focusing on the good, you know, trying to let the negative drip off your back, like the, you know, a duck's back, whatever the saying is. ⁓ and, and I love that leaning into the compassion. If you're feeling, you're starting to lose some of that empathy and some of that passion for your field. Lean into it harder, go on a volunteer trip, right? You were in Costa Rica, right?

Josh Rosen (34:03)
That's right. That's right.

Yep. Yep. Amazing. Absolutely amazing.

Dr. Cliff Redford (34:07)
Yeah, very quickly as we

run out of time. Was that your first sort of trip of that nature? Wow.

Josh Rosen (34:13)
Yes, I went there

when I was very young. I wanted like as a high school trip with Spanish class, but for something as big as this, absolutely. was a trip of a lifetime and also just a absolutely wonderful learning experience. know, everyone that was there, we were friends from afar, but we never got to work with each other before. So that was a really interesting and cool experience to be able to say that like, oh, well, we're really compassionate about

themes and different things about veterinary medicine, but we've never actually worked with each other. And then we all come together and we do amazing things, right? It was a lot of hard work. I definitely won't lie about that. It was a lot of hard work, a lot of effort to get everything together to make it successful. being able to see so many brilliant minds come together to help, you know, I want to say we helped like about 140 or 150 pets with spays and neuters.

⁓ The community was so thankful. ⁓ You you talk about fulfillment, like that's the kind of thing that really just fills your cup. Like, yes, there is nothing that I'm doing here except providing good for these people that truly deserve it, that love their animals with all of their heart, even if they live in a different culture, in a different place than we do, and their pets might fill a different role.

That love does not change. The human animal bond does not change. ⁓ yeah, it was a phenomenal experience. can't wait to go back. ⁓ From where it started to where we finished, it's amazing that we made it there. I know that you talked a bit with Joffrey about the way that everything got set up and put together. ⁓ Just a bunch of friends at WVC.

talking, know, Costa Rican spays and neuters and how we can get something like that together. It's just absolutely amazing to see it go from start to finish.

Dr. Cliff Redford (36:12)
Yeah, was, it's quite a, quite a job you guys all did. ⁓ especially the number of people I've done a lot of these trips. but it's always been essentially just me, ⁓ myself and either a technician, myself and my daughter who plays a technician like role, ⁓ informally trained. and you know, we've been as far as India and

You know, the Arctic North and things like that. And, ⁓ closest to Costa Rica was Panama. So I know exactly what you guys went through. ⁓ but I had someone on the other side that was planning it. It was more like you just come here. We're going to take care of everything and we're going to put the animals in front of you and you do your surgeries and we'll handle, ⁓ most of the organization. ⁓ but you guys, you guys put this all together and to have that many people come to, I didn't know there are that many veterinarians that got along.

Josh Rosen (37:06)
⁓ That's fair. That's right. Yes. Absolutely.

Dr. Cliff Redford (37:06)
working together. ⁓ I guess the cause will bring us together. We actually do love animals and do want to work together to help people

and their pets out.

Josh Rosen (37:18)
It was an absolute blast and that's exactly what we wanted to do, right? Like the idea with this is putting it together so that we can make this a thing that we can create accessibility to other veterinarians in the states that want to be able to go and help. ⁓ We certainly, we want that to be the future for this organization. We're working very closely with the...

Costa Rican government and the College of Veterinary Medicine in Costa Rica, which is amazing to see how interested they are. They're talking to us about all of the different places in Costa Rica that they really have needs for so that we can really just expand and figure out how we can best help. again, going back to communication, these are things that happen simply because we are very approachable, very empathetic people that we want to have conversations about how we can do better, how we can do... ⁓

Dr. Cliff Redford (37:47)
Mm-hmm.

Josh Rosen (38:11)
more. We did 150 of that when we went last. would be amazing if we could do even more than that, depending on how many days were there. We just want to make the best impact that we can. we have an amazing group of people to get that together.

Dr. Cliff Redford (38:25)
I love it, I love it. This has been so much fun talking to you. There's so much I can learn from you. There's so much the world can learn from you, the veterinarian world. How can, I know you're a speaker and an ⁓ author, how can people reach out to you? How can they follow you? How can they learn from you?

Josh Rosen (38:44)
Thank you so much for having me. This has been an awesome conversation and I'm happy to continue it at any point in time. ⁓ Anytime you guys want to reach out to me, my email address is josh at drjosh.com. I love hearing about different scenarios where you've either had a lot of success with clinical empathy or maybe you want to explore it and you're trying to figure out how to use it in a certain situation or maybe you just have one scenario you want to discuss. I'm always happy to hear about it. ⁓ You can follow me at drjosh, D-O-G-T-O-R.

J-O-S-H at Instagram and TikTok. I'm constantly talking about clinical empathy. In the next year, I do want to start doing some ⁓ CE lectures. I'll probably work with some different organizations to do webinars. Hopefully we'll be at a conference at some point talking about this stuff. I think it's just so incredibly important. I don't think I'll ever stop talking about it.

Dr. Cliff Redford (39:36)
I've been

bugging Joffrey about me joining you guys on your next trip. Maybe, maybe. You need some Canadian content in there. Yeah, you need some. We need to bring our country so these Costa Rican animals are bringing veterinarians together and they will bring Americans and Canadians together as well as the Dutch guy that organizes. I think he's Dutch. I think he's Dutch. ⁓ There you go. is a global effort. Animals are bringing us together. I love it.

Josh Rosen (39:40)
Please do. Please do, yeah?

Yeah, let's do it, man.

I love that.

Yes. Yes, he is Dutch. Yeah, you got that.

Global effort, yeah.

Dr. Cliff Redford (40:05)
⁓ I

Josh Rosen (40:05)
I love it.

Dr. Cliff Redford (40:06)
will put up your email and your Instagram and everything on the summary page as always with this episode. Josh, it's been an absolute joy. I will 100 % ask you to come back. Next time we can talk a little bit about vet stuff and we can maybe go off topic as well, but this has been absolutely fantastic.

Josh Rosen (40:25)
Love it. Thanks again for having me.