Dear Brenda: Asking for a Friend | Real Questions. Practical Advice. Better Veterinary Practices.

This episode, Brenda's flying solo — answering the questions listeners have been quietly wondering about but haven't known who to ask!

Is your team busier than ever, but the financials still aren't adding up — and you're not sure if it's a real problem or just everyone "feeling" overwhelmed? What do you do when your most talented employee turns out to be a rough fit as a leader? How do you handle a team that's begging for more accountability, but turns on leadership the moment anyone actually enforces it? We're digging into these questions from listeners and more!

These are the conversations happening in break rooms and manager meetings across the industry — Brenda just happens to have some answers. Tune in to hear where she'd start!

Thank you to Joan Marshall of PIMidlantic for sponsoring this episode! Want to take the Predictive Index Assessment? Click here!

Resources mentioned:

• From Bud to Boss by Kevin Elkenberry and Guy Harris
• Crucial Conversations by Joseph Grenny, et al

Thanks for listening!

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Transcript

SPEAKER_00 0:10

Flight Plan Quick Consult is sponsored by PI Mid Atlantic and Joan Marshall. Predictive Index helps veterinary leaders better understand what drives their people so they can hire more thoughtfully, improve communication, build stronger teams, and lead each employee more effectively. Joan is a former human resources executive who used PI within several companies before becoming a PI Midlantic consultant nearly 25 years ago. To learn how Joan can support your practice, contact her directly at jmarshall at Pimidlantic.com. Welcome aboard. You're listening to Flight Plan Quick Consult, your go-to podcast for veterinary insights that are fast, focused, and designed to elevate your practice. I'm your host, Brenda Tasma Medina from Encore Veterinary Consulting. Whether you're between appointments or heading into a strategy session, we've got takeoff ready tips, tools, and takeaways to keep your team soaring. Today's flight plan is a layover, and in our time between flights, we'll be taking some questions from our listeners in Dear Brenda asking for a friend. Real questions and practical advice for better veterinary practices. Okay, so our first dear Brenda is all about the practice being too busy and not making enough money. So this might be something that you're experiencing, but it says, Dear Brenda, our schedule looks full most days, and my team certainly feels busy, but our financial results don't seem to reflect how hard everyone is working. My doctors say they can't possibly see more appointments. My team feels stretched, and ownership keeps asking why revenue isn't higher. I'm starting to wonder whether busy and productive are two completely different things. Where would you start looking? Signed busy but bewildered. All right. And it might be something that a lot of practices are feeling. And when I dig into this with practices, I think this is, you know, a great opportunity for you to look below the surface. And by looking below the surface, I mean taking a look at some data and truly getting a sense of validation of how you're feeling. You know, if the team feels busy, they feel overwhelmed, yet the numbers, the revenue is not showing that, you've got to take a look at some other data points in order to really take a look at what's happening. So the first thing that I would do is I would take a look at my schedule. You know, how have we had any overtime? How many team members are we scheduling per full-time equivalent doctor? How many doctors do we have on the floor at once? And how many exam rooms do we have? The exam room one is one that I always go to because I often see practices who the busier they get, they they tend to want to hire a doctor. Like, we're so busy, we need another doctor, we're just overcapacity. And so they hire another doctor and then they fill that doctor out and they're even busier, and they're like, we need another doctor. So they hire another doctor. Yet they haven't added exam rooms. And this could be really, really tricky because if you only have, let's say you're limited to three exam rooms, that makes it very, very difficult for multiple doctors to be seeing appointments at the same time. As a practice manager, if I were limited to three exam rooms, I would never ever schedule more than two doctors at the same time to see outpatient appointments. Ideally, you'd like to have two to three exam rooms per doctor. However, when things are tight, two doctors for three exam rooms will work. However, you're going to hit those spots where you've got clients waiting in the lobby. If you're trying to see three doctors or you're trying to schedule three doctors with three exam rooms, you are limiting every doctor to one exam room. And that is really going to cause a problem in terms of clients stacking up as cases become more complex with those appointments. And it limits your capacity. This could really make an impact on the overall revenue that you may be producing while the team feels overwhelmed and busy because we are going to feel some sort of tension or stress if we see that clients are waiting in the lobby and we're having to go from appointment to appointment as fast as we can and trying to clean the exam room in between. And so this could very well be a capacity problem. So that's the first thing I would look at. The second thing I would look at is what are we actually doing in those appointments? You know, so pulling your ACT average client transaction numbers to take a look at where they are now. Look at your average client transaction numbers from doctor to doctor to doctor. Now it's really important that if you have a doctor who's doing a lot of surgery, that you might want to disclude surgery from this because we're looking strictly at what's going on in the most consistent way possible, which would be your outpatient exams. So take a look there and then audit some charts. You know, are we seeing one doctor's ACT be much higher than the others in the outpatient? What is that doctor doing? Um, usually it involves they're getting better compliance than maybe a colleague doctor at the same time. And we've got to dig beneath the surface to figure out exactly why that might be. Is it the way in which that they are introducing the recommendations? Is it that their language is clear, that the client trusts them in the way that they are explaining things, and therefore they they often say yes as opposed to waiting or declining? So take a look at that. It really helps to observe in the exam room from time to time to see the way that the doctors are presenting the recommendations. The more that we can get aligned there within our practice, the more likely we are to have overall better compliance to our recommendations because we have consistency that's happening. So those are the two big areas I would take a look at first, busy but bewildered. All right, the next one we have is about a great employee who might not necessarily be the best leader. Dear Brenda, I promoted one of my best technicians into a leadership position because she's knowledgeable, dependable, and respected clinically. Unfortunately, she's struggling as a supervisor. She avoids difficult conversations, gets frustrated when people don't do things her way, and sometimes just takes over instead of coaching her team. I don't want to lose her, but I'm beginning to wonder whether I made a mistake promoting her. Can someone be a fantastic employee and simply not be leadership material? Signed, second guessing the promotion. This is something I see pretty frequently, and I can honestly say that I have been guilty of this in the past. And by guilty, I mean, did you really ask this person if they wanted this promotion, or did you just promote them because they were your best team member in that particular department? So we're talking about a technician. She may have been the best technician, really tuned in to what she does every day, and she's been there the longest. And so, therefore, it seems very logical that she should be the technician supervisor. And so you give her this promotion. Um, it doesn't always equate, as far as like a promotion goes, to what this person might be aspiring to do. And so before we go to promoting someone, we really need to have some lengthy conversations and explore what career path they are they're looking for. Um often, whenever a practice that I'm working with has never had team leads before and they are contemplating putting team leaders in place, my my recommendation is create a really clear job description. So we start with that job description, and from there, we're gonna go ahead and create a job posting, and we're gonna let the team know. So we'll communicate and provide them with a copy of that job description so that everybody knows what this person's responsibilities and expectations are. And then we're gonna post it internally and externally, and we're gonna let the team know that we're doing that. That gives everyone the opportunity who happens to be in that particular department, the opportunity to actually apply for that position if they really feel that this is a direction that they want to go. It also makes it a more fair playing field when you, as the leader, are saying, I'm posting this and I'm going to interview everyone the exact same way for this particular position. Especially if you have a couple of technicians who would like to do this, go through the interview process with them. Whoever gets the promotion and whoever doesn't get the promotion is going to feel a lot better about the outcome if they were interviewed exactly the same way as the person who got the actual job. So, starting with clarity there, so that's that's one thing I want to ask myself when I read this type. Did you provide them with a clear job description so they know exactly what they're supposed to be doing? And did you really ask them if this is what they would like to do? Now, the second piece of this is training. Just because this person is your best technician does not equate to being a great leader. They have been trained in their technical skills and they excel there and they work well with the doctors. But oftentimes, our very best technicians and best CSRs and best vet assistants have never had leadership or communication training. And so that is an important component of making this type of promotion, is providing them with the most appropriate training that you can. So I always recommend, you know, a couple of books. Um, if the person is not big into reading books, they can always, you know, listen on audio books. But the two that I would highly recommend would be From Bud to Boss. Uh, this is a book that I encountered a while ago that really helps those peers move up into a supervisory role and not feel completely disoriented, and it teaches them how to deal with those problems that arise because suddenly they're having to give more direction to somebody who used to be their buddy in the trenches. And so From Bud to Boss is a great book to provide anybody that you promote to some type of a supervisory role. The next one is Crucial Conversations. This book is invaluable when it comes to leadership training at any level, because every person who's in a leadership role is going to be faced with having these crucial conversations when conflict or issues arise. And so being equipped with the skills it takes to actually have those conversations, approach these moments of stress and conflict with curiosity can really help them feel more equipped and be more successful in having those conversations with their team. So that's those are the two places I would look at. Thirdly, in this particular instance, I think it would be time, you know, if you ask yourself, do I have a clear job description? And you can say yes. Have I provided them with training? Yes. Then the third thing I would look at is sitting them down and saying, Was this what you anticipated? Ask them, is this something that you really want to do? Because I'm not seeing uh the connection between your happiness on the floor the way that I used to when you were a technician. Talk to me about that. Because if this isn't the role for you, that's absolutely fine. And that's really important for them to hear is permission to say, this isn't what I thought I was getting myself into, so that they could go back to doing being that excellent technician without feeling like they disappointed you or the practice owner in any way. So think about those three things and and go from there. Um, if you don't have a clear job description, that's exactly where I would start with this person. All right, my third dear Brenda. Whenever I ask my team what needs to improve, accountability is near the top of the list. They complain that some people get away with being late, skipping tasks, or not following protocols. But when I start addressing those behaviors, suddenly I'm being too negative or micromanaging. How do I create real accountability without becoming the manager everybody avoids? Signed, apparently I'm the bad guy now. All right, so there's a big difference between accountability and punishment. There's also, you know, this psychological safety that needs to be in place. So when I hear this, I'm immediately thinking, do we have consistent accountability happening? Because it's described as the team is complaining with with teammates' behavior, therefore I start addressing those behaviors. Well, that leads me to suspect that we aren't being consistent in setting the expectations for behavior in the workplace and then holding everyone accountable to those standards. You know, we're waiting, we're busy, we uh lose sight of those things as a manager because we're just putting out fires left and right, and those are the things that creep up. And if our team has to really call out these things, then that should be a time to kind of look in the mirror and say, what have I done to create this problem? Because I have not been consistent with the team and I need to be. So this is a time to kind of reflect on what you've been doing as a leader, but also remember that it does, it's not a bad thing to hold people accountable, and we can do it with kindness. So anytime that you have to have that conversation in terms of slipping into these types of behaviors like being late, I think it's time for a one-on-one conversation. You know, never call people out on the floor or in front of their peers, but have a one-on-one conversation and begin with. So I'm seeing a pattern that's that's cropping up, and it's come to my attention when I did payroll and I saw your clock in times that you've been late pretty consistently. Talk to me about that. What's going on? What's changed? Because it seems like it's cyclical for you. You will maybe address this, and you're really good on time for a period of time, and then you lull back into you know being late until we have to have another conversation. And, you know, truly, I don't want to have these conversations because you're an adult and the expectation is that you be on time. So let's talk about maybe some problems that might be cropping up that keep you from being on time, and let's talk about some solutions. So, you know, that's approaching it in a manner that is kind, it's coaching, and it doesn't come across as much as punishment. So think about that as a manager. What is your role in the problem, and how do you change the way that you are addressing it so that you're more consistent, you are firm, but kind at the same time. Hope that helps. All right, let's go to the next one. Dear Brenda, in the past couple of years, we've added online booking, texting, an AI scribe, a new PIMS, and several other tools that were all supposed to make our lives easier. Instead, my team sometimes feels like they have more systems to manage and more places to look for information. How do I know whether technology is actually improving our practice or just creating digital clutter? Signed, drowning in apps. All right, this is a favorite one of mine because I am I'm very innovative, I love new technology, um, I love to help practices through these kinds of transitions and changes because I want to see them have better work-life balance, I want the clients to have a great experience, and I want the patients to be well taken care of. So I'm often helping practices with a PIMS transition or helping doctors to start to use an AI scribe. The key is what are we replacing the technology with? And so often I see new technology layered on old systems, and we haven't cleared the decks and made room for that technology because we're still following old policies, all old protocols, old SOPs, and we're still using the old technology to a degree. So, in order to launch these types of changes in your practice, you really need to do one at a time. And you need to have a plan for it, and you need to timeline it so that you're giving your team adequate time to actually train, understand the new technology, understand what they're replacing the new technology with, and allow everybody to get aligned and on the same page to using the new technology consistently. You need to build in checkpoints so that at each checkpoint the team has the opportunity to discuss what they've discovered, how it's helping, the stumbling blocks, and that open discussion can lead to your higher performers with the technology helping those who are really hitting those stumbling blocks. So start there. It sounds like we've tried to do too much in one period of time and not really let things stick before we went on to the next thing. So anytime that we're doing strategic planning, I always limit the year to like three big changes. And if PIMS is one of those changes, I really would like to limit any other technology that you might be adding until that conversion is complete and put to bed, and everybody's humming along and really getting the hang of that new PIMS. Um, AI scribes are amazing, they're wonderful. I think that there's an opportunity to beta test a couple of different AI scribes with your doctors and allow them to select one that they're all going to agree to use. This is gonna enable you to create training and a transition plan for your entire team so that everybody is aligned to using that particular AI scribe, and we become much more efficient with it. So take a look at what you're doing, do a full audit of all of the different technology platforms that you're using, your team is using, and take a look at identifying what that technology is meant to replace, and then check in with the team to see if we in fact put the old technology to bed and we're no longer using it. If we can declutter there, it will make a difference with your team. Hope that helps. All right, and our last one is Dear Brenda, I'm a practice manager, but most days I feel more like the hospital's emergency response team. Someone calls out, a client is angry, the schedule falls apart, a doctor needs something, the printer stops working, and suddenly it's 5 30. I know how you feel. My strategic projects keep getting pushed to next week. I know I'm supposed to be working on the practice instead of constantly in it, but I honestly don't know how to get there. Help. This is signed manager by title, firefighter by trade. And I hear this often. I've seen it, I have felt it. And you know, when I felt this as a practice manager, I really had to take a look at the way that I. Was organizing my week and the way in which I was interacting and with my team and getting things done. Practice managers who are the firefighter tend to be the type of practice manager that everybody's kind of dumping all their problems on. And this typically indicates that we don't have a strong middle level management team, if you will, on the floor. So I would ask this manager: do you have a strong technician lead? Do you have a strong CSR lead? Do you have a strong vet assistant lead? And do you have a medical director? Because if so, you know, some of these things that are coming to you to put out fires probably needs to be going to those people. And if they are bypassing those people and coming straight to you, then the team doesn't have real clarity on what those middle-level manager roles are all about. And so this comes down to really building that team and reinforcing that they are a peer group that works directly with you to really keep the day-to-day going within your practices. So I'll ask a practice manager, okay, great, you've got this team in place, but how often are you meeting with them? And I often do not hear that they're meeting with them regularly at all. It might be one-on-one touch points with each one of them, but they're not bringing that particular team together often enough. And so when I was in practice and I had built that middle letter level team, we met every week. It was super important. And not only was it about what's happening in the practice and what we need to fix and what's going on, but it was also about checking in on different projects that were happening. It was checking in with one another in terms of how are we supporting each other. You don't want to go into these meetings thinking, okay, I'm the CSR lead. Here's all the issues the CSR has, and just dump it on the table and expect other people to fix it. Same thing with the techs. So I've seen this dynamic happen in these leadership meetings where they're bringing all the issues and kind of dumping them on the table and expecting one of the other departments to take care of it. You truly are a leadership team and you need to function that way. You need to have each other's backs and you need to work together to solve or resolve these issues that are creeping up that might be interdepartmental, they might not be, but we've got to work together. So always start those meetings with some type of a team bonding or team building question or an icebreaker and incorporate some leadership education into it as the practice manager, but then talk about the real things that need to be fixed and need to happen and assign ownership to someone on the leadership team. It's not up to you as the practice manager to do all of these things. Yes, you will have oversight, but you need to assign ownership. And then once you've assigned ownership, you need to assign a timeline and a deadline for getting that particular item fixed. And if they're not checking in with you by that deadline, then you need to proactively go to the person that you assigned ownership and find out what the problem is. Do they not have the resources? Are they not quite sure what to do next? This is your opportunity to coach them into being more autonomous on the floor, and it empowers them to make decisions and choices based off the mission and core values of your practice. I hope that helps. And I want to thank you all for flying with us on Flight Plan Quick Consults, and thank you to our generous sponsor, Joan Marshall, at PI Mid Atlantic. If today's insights helped you climb to new heights, be sure to subscribe, leave a review, and share this episode with your crew. And for future Dear Brenda episodes, please feel free to send your questions into consulting at Encorevet.com.