Episode 73:

 

[00:01:12–00:04:42] Understanding the Effort-Reward Imbalance Model

All right. Welcome back to another episode of Stop the Burnout. So today, we're talking about the reward, effort, and balance. This is gonna seem like no shit, common sense, but when we really break it down, it's like a, a scale, and we're trying to balance out the weight on either side. But an imbalance is when we're putting in way too much more effort than we're getting out of it, and obviously, that sets us up for burnout.

So I did a previous episode. It's actually episode 40 and 41 on this, so I talk a little more about what it is and a little more in detail. But today, I really wanted to focus on the solutions, how to start changing things today that you can do even if you're not a [00:02:00] practice owner or even a veterinarian, and the neuroscience behind it.

And don't you worry, just like the intro said, we are definitely gonna go over some research that is out there that you can show your, your bosses, management, whomever that hopefully this will really help to help literally the bottom line but also help you in your job. So just a quick backstory on effort-reward imbalance model.

So this was created by Johannes Siegert. I believe that is how you say that name. And the definition is basically this lack of fairness in job exchange that harms our mental and physical health over time. Okay, it's not super descriptive. But essentially, think of, like, those scales... I feel like we used to use these maybe in, like, science class, where it's the two scales, right? And you have to even them out.

They have to have weight [00:03:00] to equal both in order for them to, like, sit at the same level. Obviously, if you have weight on one side, it's like a seesaw. If you have weight on one side and none on the other, the one that has no weight will go up, right? It's just finding that balance. So effort, though, when it comes to work, is gonna look a little bit different, obviously, based on your profession, but think of the effort as the demands of the job, the time pressure to do it, obviously heavy workload, plus or minus physical, duties, or emotional requirement.

But the reward is not always just money. Sure, we have to factor that in, salary, raises, retention bonus, m- all that stuff. But it is also intangible things like respect, support Your self-esteem and confidence. Also, though, your status. Do you have the ability to [00:04:00] advance in your prof- in your profession, m- yeah, in your role, regardless of if you're a sport- support team member or a veterinarian.

So it doesn't, it's not always gonna be very clear-cut, and again, certain things are gonna motivate people differently too. So this is gonna be very individual based. So all right, we're just gonna get right into it. How do we make it so that this scale is balanced? Because if you're listening to this podcast episode, you're probably the type of person who feels like we're exerting so much energy and time and effort and not getting the same type of reward back.

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[00:04:43–00:06:03] When Effort Outweighs the Rewards of Your Job

 

And again, it's not always a money thing. Certainly, I know our support team members are grossly underpaid, and I would say veterinarians too, compared to our human counterparts. But I think, again, we have to look at what is the reward that we're getting too [00:05:00] 'cause I think that a lot of the things that are intangible, so the respect, autonomy, growth, being part of a team, utilization, all of that we can't really put a price on.

So when we jump into all this, number one is we have to look at, okay, if I'm trying to figure out where I am on the scale, because if I'm exerting so much energy and I'm not getting that reward back, that's when we start to burn out because we typically can't and don't just stop putting all that effort in, right?

Because to a certain degree, we c- we can't in the sense that, you know, I can't, like, half-ass a surgery. I guess you could but wouldn't recommend it. But it's that same thing of, like, you still have to meet a certain baseline. So then we know the scale is going to continually be unbalanced. [00:06:00] So first thing we do is, all right, find out where this balance or imbalance is going on.

[00:06:04–00:10:10] Audit Where Your Energy Is Going at Work

So we do an audit. So things you wanna ask yourself are like, where is most of my energy going? And this isn't something that you'd probably wanna do at work 'cause you're probably busy, but 10, maybe 15 minutes, even on your drive home, think about this, es- especially if you're listening to me while you're driving.

Where is most of my energy going in your job? And where are parts of this that maybe don't actually require that you specifically have to do them? So if you're a veterinarian, sure, you're gonna be doing the surgery, right? We're not gonna have y- an assistant like, "Oh, you can do this." No. But what I see time and time again, and this was what prompted to include this in the beginning, was that actually I think at this point it's probably every coaching client I've had, it's this imbalance that [00:07:00] contributes to burnout.

Now, there's a lot of nuance of why this imbalance happens. Maybe there's the perfectionism, the difficulty saying no, trouble setting boundaries, you know, lower self-esteem and self-worth. So all that can contribute to the imbalance, but essentially it's this imbalance is what gets us to burnout. So if we're taking an audit, we wanna look at, yeah, am I doing certain tasks that don't actually need to be done by me specifically, but I'm doing them because, my favorite, is well, it's just faster if I do it, or I'm just gonna do it 'cause it'll get done right, and then I won't have to redo it.

Does any of that sound familiar? And a lot of times we're doing this through perfectionism, over-functioning, the fear that someone else is gonna do it and fuck it up. And again, it depends on what task we're talking about. Are we intubating or [00:08:00] are we taking a history? Those are obviously two different things.

But as part of that audit, also asking yourself, "What am I getting back?" So yes, pay is in there, but do you have the autonomy, the ability to make decisions without a lot of like micromanaging oversight? Are you appreciated? Do you feel like there's an opportunity for growth in your role? Do you have the respect, maybe the flexibility of a schedule?

And that can be all as a technician, as a veterinarian. But we wanna ask ourselves that because you could... Here's the other thing. Sometimes this is where we gaslight ourselves. You could have a great schedule. You could have a team that is respectful and nice, and you enjoy working, but you can still burn out.

And there's something that [00:09:00] is imbalanced. So where is that? Is that because you've got a great team, but you have 40 appointments that you have to see, 15-minute sick appointments? Right? Like, that- that's the imbalance 'cause you're exerting a lot, and you're, you still have a great team, and that's great, and that part isn't an issue maybe.

But you're still imbalanced because you're just giving so much more than, than you're getting in, in reward. And there is a point in time, I will say, that the imbalance doesn't fucking matter when you're so burnt out. In other words, it's great. Most people like money. We work harder. We get paid more. We work more hours.

We get paid more. But it's a bell curve, because I've done this so take it from me, because to a certain point, money is great, but the more you work, the more hours you work to get paid more, there's a point that the benefit isn't there. And that can be really [00:10:00] challenging because if you set your lifestyle up to meet a certain minimum, you're almost, like, holding yourself hostage with, "Well, fuck, I have to work X number of hours a month."

Like, this can happen in relief work. "I need to work X number of hours a month minimum to continue this lifestyle or have to work more." And if you're burnt out, that's a recipe for disaster.

[00:10:11–00:15:00] Stop Doing Tasks That Are Not Yours

So number one is audit. Number two- This is like the meat of it, but stop doing the tasks that aren't yours. So a vast majority of my coaching clients, not all of them, but a vast majority, as in this particular case, veterinarians, they're doing technician tasks and skills, and there's a multiple, multifactorial reason for this.

And this can happen with technicians too. Maybe you have an assistant, but you're not able to utilize that assistant [00:11:00] because they get pulled someplace else, and now you're left doing the job of two people. And this isn't-- I'm not saying let's dump everything on technicians. That's not what I'm saying at all.

Because sometimes I say this, and technicians are like, "We're already so busy." I'm like I know." But sometimes the reason that you're so busy is because you're understaffed, and the reason you're understaffed is because your leadership team is not utilizing the support team members, and they end up leaving.

There's no growth. There's no autonomy, which there's some research behind this, which I'll go into. So the reason why you're stuck doing so much is because of that. So if you're like, shit falls down the hill, right? Rolls down the hill. So if you're at the bottom and the people above you left you're gonna be taking more shit, right?

So it's the same type of thing. And I'm talking about... Oh, sorry. That's the timer I had on. But I'm talking about doctors doing, and this is like, this is [00:12:00] what? August 2026. The, like, I've had these conversations this month with my coaching clients. Doctors doing blood draws, nail trims, taking X-rays, running the blood machine, processing lab samples, ear cytologies, fecals.

And it's not from a, "Oh, that's not my job description." It's a, we haven't trained either, there's two things that I see. We haven't trained our support team members enough that we're comfortable with it, which is a, that's the vast majority that I see, or we haven't allowed them to do that, or we haven't hired the people that can do those things.

So what do you have a technician for? To hold an animal? Is that it? They can do so much more. Again, we'll kind of get into this, but that's where we end up exerting so much energy and effort, and we don't get it back, and that is what is very exhausting. So [00:13:00] these clients of mine are putting in charges.

They're reading ear cytologies. They're obviously going in to examine the ear and talk to the owner and get a treatment plan, and then they're putting those charges in, filling meds. Like, what? W- w- what? I can't even comprehend it. So n- it's just, it's wrong for so many different reasons. And again, I'm not saying that dump everything on technicians.

That's not what I'm saying. But if, think of the doctor as a producer. I'll try not to make this too business-y, but the doctor's a producer. The more you can get them to see things as far as, like- clients and patients and cases, the more money they're able to bring into the hospital. So this is what cracks me up about private equity and corporate is what is their bottom line?

The bottom line is money, and that's usually what is very driven for their decisions. But they literally shoot themselves in the fucking foot [00:14:00] because they don't train anyone, n- besides the point that they don't pay them what they're worth, but they don't train them, and then they're literally letting money walk out the door, so to speak, because People are calling, we can't get 'em in to be scheduled, the doctors feel stressed, but when I'm getting down to it talking to some of my clients, we're realizing, I'm like, "You're stressed because you're doing technician work.

You're doing the job of two people." And it's not that your team is lazy. Many times it comes from higher up. So think about that. Even administrative tasks. So one thing that I used to... Didn't happen all the time, but when I was in general practice, I'd call a client back, and now I'm like, "Oh, shit," "the T4 is low," but maybe it's, it, it's a dog.

Maybe it's euthyroid sick, so I wanna add a free T4. So let me call the lab. Oh, cool, they still have the sample. Call the [00:15:00] owner.

 

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[00:15:00–00:17:00]Delegate Administrative Tasks and Change One Thing at a Time

Owner's like, "Yep, let me go ahead. I, yeah, we can definitely do that." Now you're like, "Okay, well, we're adding on another test, so now they owe us money," right? To put it bluntly. So I would just be like, "All right, let me..."

I'd have them transfer, but doing the paperwork, putting the charges in, like a client service representative can do that. My, my time spent as a doctor, now granted this is, like, a small slice of the pie, but if you're doing this on repeat or something similar, it is not efficient, and it's burning you out.

So administrative cha- tasks, even like I used to book, like, "Hey, when do you wanna come for your re-check appointment?" Right? Like, sometimes it's fine, you're on the phone, but have your CSRs do that, the ones that are really good, and they're fast, and they know how to book it. So that's, these are little things to think of that we don't think about.

The other thing is we have to look at through the lens of it can be very frustrating because if [00:16:00] you are in one of these practices that we're not utilizing our support team, the workflow sucks. We tend to want to, like, revamp everything because we're so frustrated. But the hard part is if you do that, you will be more stressed I guarantee it.

So we wanna focus on one task or training one person and doing that in a way where we can see the results of that before we, like, do this straight across the board. So we're not trying to recreate the wheel. We're just trying to change one thing because ultimately in that process, A, we learn does that work, how we went about it, and then B W-what else do we wanna tweak?

Are there things we wanna roll this out different next time, right? Instead of, like, upsetting everything and trying to revamp the whole schedule, tomorrow. [00:17:00]

[00:17:00–00:18:59] Test Workflow Changes Before Making Them Permanent

So a lot of times too when we try something different, and I have a coaching client that she said the way they ha- were doing their technician appointments, they changed it a little bit so it was more efficient.

The doctors had more time. Like, the way that it worked, there weren't bottlenecks essentially, and her practice did do it right. They're like, "Let's try this for two to four weeks." That's another thing, trying it for a set period of time because a lot of times people just in general are opposed to change.

So if we know that, hey, this isn't forever, we might tweak it and change it. We just need to try for two to four weeks to see if we wanna keep this and maybe make changes or this is a fuck no, we're never doing it again. So it's not forever. So going back to the tech utilization, the AVMA did a study in 2022 that when we better utilized, and [00:18:00] I believe this was talking about credentialed technicians, but when we better utilized technicians, it, it increased revenue, bottom line, which is not...

Like, no kidding, right? Like, do we really need a study to say that? We-- I would agree, right? That's not a far stretch, but I think a lot of practice owners Are missing the boat and the opportunity here, especially if we feel like, "Oh my gosh, either all these clients wanna come in, I don't have any slots to put 'em in," that's not a great problem to have, but it's a still problem, or, "Oh my gosh, I feel like w- we're not as busy.

How do we streamline this?" That's a great time to do this, is when you're not busy. Get your team trained up to a certain level so that when you do get busy, you're streamlined, that workflow happens. So another study, this was [00:19:00] published in the National Bureau of Economic Research, Anne Bartel.

[00:19:00–00:21:09] Why Investing in Training Pays Off

Now, guys, this was like this was published a bazillion years ago, 1989.

I say that 'cause I was born in '83. So it's not a recent study, but I think there isn't probably a recent study, at least that I know of, because this is obvious, it's the same thing. What they found, and this isn't in vet med, this was just businesses in general, that there was significant greater growth in labor productivity.

Okay, this isn't, like, manual labor necessarily for vet med. But there was significant greater growth in labor productivity, and it was actually enough to catch up to comparable businesses, meaning, this is what I hear all the time, "Oh, well, we don't have time to train the technicians. That would mean we have to pull back and not do as many appointments so that we can have enough time to train," or, [00:20:00] "We have to make the appointment times longer."

And so that is, like, the number one thing I hear, like, "We can't do that." And I'm like, "You can't afford not to do that for that exact reason." There is a study that literally says, that time and money that you spend doing that will pay you dividends, and you won't be behind. You can literally catch up to comparable businesses when you are able to do things correctly, and I would argue probably surpass comparable businesses that aren't doing the same thing.

So that to me is not an excuse. I get it. You got bills to pay, a minimum that you have to pull in as far as a practice goes. But it's like anything else. It's like compound interest. You put money in an account, and it's compound interest. Do you look at it and say, "All right, I put $100 in there. Eh, I could just really use $100," and you take it back out?

Or you put it in, and you let it marinate, and you're like, "I know this is gonna pay off. It's just gonna take some time," like maybe some years in that case. [00:21:00] Yeah, that's the exact same thing. We know that. We know what compound dinterest, interest is. We know how it works. Why are we not doing this for training for our support team?

[00:21:10–00:24:59] Underutilizing Veterinary Technicians Hurts Retention and Revenue

So the other aspect of this is in 2023, AHA did a study- And one of the top, I don't-- It might have been the top, but one of the top reasons veterinary technicians, and they were referencing credentialed, credentialed veterinary technicians left a job was due to under-utilization. So I know pay was in there too, but I don't think it was number one.

So again, going back to why are we not taking the time to train people? Because if we are utilizing our credentialed technicians, and I, side note, I have no issue with on-the-job trained technicians. I've worked with a lot that have been phenomenal. [00:22:00] Obviously, for the sake of the study, it was on credentialed technicians.

But I've also talked to you coaching clients who have all credentialed technicians, and they don't read your cytologies. So it, like that's a, that just baffles my mind. So essentially, underutilization was a problem for those technicians, and rightfully so. It's like a, a doctor, maybe you love surgery and you know, a veterinarian, you love surgery, and then you go to a practice and they're like, "Well, you can have like maybe one surgery day a month or a quarter."

Right? Like, "Okay, well, I'm not doing the thing that I enjoy. Why wouldn't I wanna do this?" And with that comes autonomy too. But in this study, this AAHA study, they also found that one hundred and five thousand to one hundred and thirty-seven thousand dollars [00:23:00] per credentialed technician per veterinarian, kind of a weird way to put it, had an increase in revenue benefit.

In other words, per credentialed technician, literally, I think this is annually, a hundred and thirty-seven thousand dollars more revenue you can pull in. Now, the other side of me is like, "Then we should pay our technicians better," especially our te- our credentialed ones. But to say that either I can't hire a credentialed technician 'cause it costs too much is bullshit, because that tells us right there why we should be doing that.

And again, no shame to our on-the-job trained as well. And they also found in the study that the median revenue per DVM, so per veterinarian, was thirty-six percent higher than The DVMs that were [00:24:00] performing technician skills. So essentially, if a veterinarian was not performing the skills that credentialed veterinary technicians, and I'm not saying, like, stuff they're not supposed to do, I'm saying the stuff that they're trained, tested, and is an ade- an appropriate skill for them.

So if the DVM never did those, their revenue increased by 36%, so a third more. This is ... Please, if you're listening to this, just go Google those research studies and pull that off and go show management, because there's no excuse of why we have to work in these practices because, again, it, it hurts the veterinarian 'cause now they're burnt out, they're doing a lot.

It hurts the technician because they're twiddling their thumbs. They're bored as fuck because they went to school also for two years, and now they're a glorified holder, n- you know, no fault of, like, an assistant, but it's, again, we're not giving them [00:25:00] enough credit of what they can do. And I, and I do think, you know, there's part of this where some veterinarians don't even know what credentialed veterinary technicians can do 'cause I've worked with some of them, and they're

[00:25:11–00:26:41] What Full Technician Utilization Can Look Like

Guys, it ... They're awesome. And when you can streamline that ... Case in point, I worked at a practice, every single technician they had, and this isn't a requirement, so I'm in Florida. We don't have, like, title protection or requirement of technicians to be credentialed, but at this practice, like, that's their standard, which is fucking awesome, and honestly it was probably one of the, it is one of the top places I've worked.

And so with that, though, their technicians have already had the heartworm talk. Like, and that's not, right? That's not their full skill set. Their technician talk, their, uh, excuse me, their heartworm talk, prevention, meds, "Oh, your dog's on fluoxetine, but it's not work-" Like, they've already had all these conversations by the time the doctor goes [00:26:00] in.

So those doctors that are banging their head against a wall because you keep having the same conversation, your technicians, a lot of times they would come to me and be like, "We talked about a dental," like I haven't even gone into the room yet. "We talked about a dental. They, they're, definitely wanna do that.

They might ask you some questions. I talked to them about, you know, the, the flow of how that happens, the anesthesia, the" I'm like, "Fucking cool." That is possible, and I, I hope that for this profession because I, I ... It's a win-win, for sure. Okay. The last two here are Okay, if we're looking at all this effort that we keep giving out, is there a way we can increase the reward to balance it out?

[00:26:42–00:29:23] Increase the Reward Beyond Just Money

So I said earlier, there's definitely a bell curve, because at some point, it doesn't matter how much shit you have, money you have, stuff that is given to you, time off. If you continually... If your effort is still an upward trajectory, then at some point, [00:27:00] those two aren't gonna meet, and it's gonna be a problem.

So how can we increase the reward? Well, obviously, raises, right? Retention bonus. Now, obviously, that is not always in our control. But think of those things that are not tangible, like money, that I mentioned earlier. So certain skills, maybe there's certain cases that you enjoy. I know some technicians that, like, really love doing dentals, some that hate it.

Some doctors, same thing. They, like, really like doing dentals, or they really like skin cases. It's like, why can't we... I'm not saying book every single one under them. But if someone calls, there's openings in both doctors' columns, but you know if it's a skin thing, and Doctor A likes skin stuff, and she has availability, like, uh, it's just, that doesn't take a lot to do that.

Because in that case, pet's coming in, it's gonna see whomever anyway. Can we just put them to the cases that they like? And not that, [00:28:00] again, there's a lot of nuance to that. It's not like that's all they'll see. But when that's recognized, especially some... A lot of times, the client service representative, they don't know that.

So this is another way to look, like, how can we create more of that reward that is beneficial? And I get that is hard when we're burnt out. But even things like respect, appreciation, autonomy to make decisions. So I worked at a practice that around the holiday time, they would give the technicians like maybe 50, $75 that they could award to any client that they liked or for whatever reason, which I thought was really cool.

So they would literally call up the client and be like, "Hey," and usually, you know, they had a good rapport with the client, and they knew who they were. A lot of those techs had been there for a long time. "Hey, it's so and so. I just wanted to let you know that, you know, the practice [00:29:00] extended this to us, and I'm gonna put it on your account as a credit."

And it was just like a feel-good thing, right? And it really didn't cost the practice that much money, but the technicians could give it to whomever they wanted. So it just creates that appreciation and that, like, it feels good to do something for someone. So that's another way of looking at that. Okay.

[00:29:24–00:30:00] Focus on One Task or One Person to Train

And then the last bit here is, again, focusing on maybe it's one task to delegate, doing your cytologies maybe, right, to your technician that's maybe never done them. It's not, "Okay, let's do ear cytology, skin cytology fine needle aspirate. We're gonna do all the..." No, focus on just one thing and get really good at that.

So one task to delegate, or maybe it's that one person to train. Like maybe it's a float technician that is good, but they don't know anything about talking to owners about [00:30:00] harm prevention or whatever it is.

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[00:30:00–00:32:45] Start Small and Improve One Part of the Workflow

harm prevention or whatever it is. So training that one person. And I love, I know it's not always feasible, but I love cross-training because then when someone's out, you can pull a receptionist to work technician or vice versa.

That is very, very valuable. So I know that's like a, a nice to have. Like, let's just at least train the people for the position that they're in. But that's another way to look at it. So we're not recreating the wheel. We're not trying to do this whole big thing that we're like, "Oh, we're gonna redo the schedule."

Sorry if you can hear this. My dog is sleeping. He has his foot against the wall and keeps scraping. But we're not recreating the wheel. We're not like, "All right. This is a new schedule. We're going with it." Another way to talk to management about that is, "Hey, can... Are you open to hearing a little bit about our workflow of checking clients in?"

For example. Or are you open to hearing how we can improve [00:31:00] taking a better history or a more efficient history, right? That sounds a lot more open, and there is some psychology behind that of why we ask first "Are you open?" But we're not saying, "Hey, we need to fix how histories are getting done."

Because the problem with that is if it's affecting, and this is what I found a lot, if it's affecting maybe you as a veterinarian, but it's not affecting technicians, management, it's not affecting them, but it's making more work for you as a vet they don't see the benefit of changing it 'cause they don't think it's fucking broken.

So that is important of, "Hey, can we improve this?" So even just the words are super helpful. Okay, so quick recap. Audit, figure out where are those energy leaks, what am I doing that maybe isn't required of me to, again, stop doing what isn't required of you. And I know that that is hard, and all my coaching clients know I say it frequently is we gotta let shit hit [00:32:00] the fan sometimes for you stopping to do every single thing in order to realize where there is a problem because that's, that's the thing.

Well, it's getting done, so at the end of the day, this thing is done. Who cares? But someone might not realize it's you that's been doing it. So we stop doing the things that aren't ours. We talk about efficiency, those studies that were done, uh, utilizing our credentialed technicians or technicians just in general.

Number three, can we increase the reward? Maybe that's the type of cases that we see, where we're put in the hospital, like we like to be on surgery or we like to be on appointments. Not solely, but maybe if there is a ability to put people in certain scenarios that they enjoy better, that's one way to do it.

[00:32:46–00:35:29] The Neuroscience Behind Effort and Reward

Okay, so all those are good. Quickly, the neuroscience behind this is hugely important because what's happening is our brain is really trying to calculate, and it does do this. It [00:33:00] calculates this reward versus the expected cost or effort, right? Like maybe, have you ever had someone ask you to do something and you're like, "Fuck, I really don't wanna do this," but it...

This is a great example. "Will you work this extra shift? I'm going out of town with my family," or whatever, and you're like, "Ugh, I really don't wanna do that, but I could really use the money," right? It's like that inner dialogue is like, "Oh, fuck. I don't wanna do that. Oh, I could use the money. Maybe it won't be so bad."

So our brain is always trying to calculate that, and it's actually several different parts, but the ventromedial prefrontal cortex is the part of the brain that is focused on the reward predictions. We're trying to predict is that award what we want and what is gonna be the end result 'cause we don't always know.

Obviously if you pick up a shift, we, you know you get paid. Um, but it could be different scenarios. But there's also the ventral striatum, which is the part that's [00:34:00] responsible for looking at the subjective value of things, and this last part, which I know I've talked about before, but the dorsal anterior cingulate cortex, that's a part of the brain that really evaluates the choices and rewards.

So this isn't just a, "Oh my God, works hard." There's neuroscience behind this of what your brain is trying to predict and maybe You know, that, that working that extra shift and that money for whatever reason at this point in your life is more beneficial. Like, hey, that, I know the day's gonna suck, but I need that money.

All right. That- that's where we look at that. So the other aspect though we have to think about is dopamine is involved in obviously motivation, learning of rewards, our willingness to expend energy for something. But the problem is if our work really requires this considerable [00:35:00] effort with not really, I would say inadequate and unpredictable payoff, the brain's like, "Nah, no thanks.

That's gonna cost a lot, and it's not gonna pay off." So that's where when we have scenarios at work, it can be really challenging because what our brain also does is once we expect a certain outcome, this cognitive bias, our brain will always look for things that support it, whether it's true or not.

[00:35:30–00:38:01] How Stress and Cognitive Bias Keep You Stuck

That's why, in other words, there's, there can be the same scenario, but two people have totally different views on it because of sometimes experiences, but also it's what you believe things to be in a certain way. Like, someone could say, you could say, "Hey, your dog needs to be on heartworm prevention," and the owner's like, "No.

Like, I don't see the, the benefit. Like, it's gonna be costly." Right? Maybe they got a huge Great Dane, and they're like, "No, that's, like, a lot of money." And in our mind we're like, "Yeah, [00:36:00] but that pales in comparison to treating that Great Dane w- with immunocide injections and the whole workup and diagnostics with that and crate rest and all that."

So in our mind we're like, "That's stupid." We also have pr- maybe seen heartworm positive dogs, and we know the things that it can cause. So in our mind it's a no-brainer, but based on their experience, they're, they don't know necessarily any of that, and so they're just seeing a cost. So you see where that, like, imbalance is, but it's the same situation.

It's just two different scenarios based on what you know to be true. Obviously in that case we know heartworm, like, we don't think that's true. Like, we have evidence that supports that but you can see how that works. So it's like one of those things when you're having a bad day, you're like, "It just keeps getting worse."

That's 'cause our brain is looking for that unfortunately. So when you're anxious going into work and you're fucking stressed out, your brain is gonna look for ways that work sucks, and that's, that's the tough [00:37:00] part. So that's how we get stuck though. The other thing that adds insult to injury here is the prefrontal cortex part of the brain, that, that's the part that's responsible for emotional regulation, decision-making, very, like, detail-oriented stuff.

That kind of goes offline to some degree when we're in fight or flight. So when we're in that, like, really anxious energy and we're in fight or flight, our prefrontal cortex isn't working up to par, and that's the part that we really need to be able to process, okay, is this really, like, reward, effort, benefit?

Because we can't really process the reward, effort, benefit because our prefrontal cortex is offline. So what happens is the more overwhelmed we get, the more we actually need that executive function. But because we're so stressed and overwhelmed, the more it goes offline. So it's [00:38:00] like negative feedback.

[00:38:02–00:39:41] Why Familiar Misery Can Feel Safer Than Change

The more stressed we get, the less we actually get from, f- helpful from that. So that's why we stay stuck, and because it feels really hard and challenging to be like, "Oh my God. What is... How do I get out of this? This is, this sucks. I don't know what direction to go in." A lot of times we're like, "I'm gonna look for another job," and then we go look and we're like, "Oh, fuck.

I don't know. I gotta change up my commute. That's gonna change my schedule. I gotta tell my boss," and go through that whole... Like, that reward effort doesn't seem beneficial, 'cause we don't know what the outcome's gonna be, right? Is this other job gonna be better? 'Cause the misery that I'm in now, at least I know what that misery is.

And I know you've heard me say it before, but it's that familiarity that our brain craves, and that's why we just stay stuck in these cycles of like, "Why the fuck am I so miserable, and I keep doing this every day?" So there is [00:39:00] neuroscience behind it. I will say, too, I'll just throw in that being neurodivergent, our ADHDers, myself included, our dopamine is low on a good day, so it's going to be really hard to g- get motivated to do things.

And the more overwhelmed you are, which we tend to be, I guess you would say, than someone that is neurotypical, but we tend to be more sensitive to sensory things, so sounds, textures, noises. And so we can be overwhelmed quicker, and then our prefrontal cortex goes offline 'cause we're in fight or flight, and like, it's just that cycle.

[00:39:42–00:41:22] ADHD, Dopamine, Hormones, and Burnout

It's literally that cycle that just keeps repeating. So that's why we stay stuck, 'cause then on top of that, we're fucking tired, and we don't have enough dopamine, so we just continually stay in that place. The other thing I will add, just throwing it out there, but if you're perimenopausal, for [00:40:00] ADHDers, I'm fairly certain, I have not seen the study specifically- if you have ADHD and you're in perimenopause, you're more likely to go into perimenopause earlier, which I was never told.

I also didn't, wasn't diagnosed with ADHD until last year. But your executive function obviously is ... it's all fucked up because the dopamine and estrogen have a synergistic role. So if your estrogen is fluctuating, your dopamine's gonna fluctuate. This also happens though even if you're not perimenopausal, and being someone that goes through a menstrual cycle, your estrogen obviously changes during that 28-day cycle.

That also affects your dopamine, and that's ... I mean, obviously, right? There's sometimes around our period ... i'm sorry if there are men listening to this, but most of this is probably women. That's why around our period, right, we feel unmotivated. Our estrogen is all [00:41:00] over the place. I mean, there's a lot of other reasons for that.

But I throw that out there because if you're struggling, don't feel like, "Oh, I just have PMS." It's like there's literally a hormonal cascade of things going on that affect, like, your dopamine. So if you're burnt out and then you get your period, it's probably gonna feel a lot heavier. Throw in your neurodivergent, fuck yeah.

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[00:41:23–00:43:14] Final Thoughts and Burnout Breakthrough Coaching

So all of that to say I hope that you guys got a little something out of that, hopefully more than just a little. I would love it if you did get something out of it to share this with a friend or colleague so that this po- podcast can get shown and listened to more people. We get to reach more veterinary professionals and hopefully stop these cycles of burnout.

But if you are interested too in how I do work with my coaching clients and all the stuff that we talked about today, I have coached them one on one, and in their individual scenarios and whatever challenges they [00:42:00] have, obviously it's completely tailored to you. But if you're like, "Hmm, wonder what that's like 'cause I am stuck in this cycle and I don't know what the fuck to do" go ahead on Instagram.

You can DM me the word apply, A-P-P-L-Y, or go on my website, thestressandburnoutcoach.com/application Or you can grab the link in the show notes here, and you can apply for a complimentary 45-minute burnout breakthrough session with me. We'll get really clear on what that burnout cycle is for you and your next few steps to start healing.

And if I feel like we might be the right fit, I might even invite you into one of my coaching programs. So if you're interested in that, now's the time. You've probably waited more than long enough, and waiting longer doesn't mean that you're going to all of a sudden wake up one day and figure it out and feel better.

In fact, if you were going to be able to figure it out really quickly, you [00:43:00] would've done that by now, 'cause you're a really smart person. So anyway, I would love to hear from you guys. Send me a DM on Instagram too. I wanna hear your take back. What ... Or takeaway. What's your number one thing you learned on this podcast episode?

All right, guys, I'll see you on the next episode