Epi 59:

[00:00:00 - 00:07:59] How Vet Med Became a Customer Service Industry

Ever walk out of an exam room thinking more about what you said to the client than the actual medicine itself? Yeah, that's not a coincidence. Vet med is being run more and more like a customer service model, and it's changing everything. This isn't completely new, but the effects of it are really affecting everyone in the industry.

So let's talk about what that means for you and why it could be contributing to your burnout. Let's go.

Hello, everyone. Welcome back to another episode of Stop the Burnout. Today's episode is something that I've been talking with recently with some of my coaching clients, and I feel like we live this every single day, and we don't realize the impact that it has on us, and that is how veterinary medicine is turning into...

Well, I wouldn't even say turning into. It is a customer service-based industry. So I wanted to talk about what that is, why it is, what that looks like, and also how you as a listener and someone as a part of veterinary medicine can work with this so that it doesn't deplete and drain you and contribute to burnout.

But it's something where, you know, I think with this business model, we don't essentially ever end up, like, putting ourselves first in a way. All right. There's a lot of nuance to this, so make sure you listen to the whole episode. So what really happened, I think kind of like zooming out and looking at veterinary medicine, I

This is gonna date me, but I started as a tech. I use that word in quotes. I was not certified. As a assistant, I guess I would say, in 2000, okay? So 26 years ago. And I was in a six-doctor practice. We were open seven days a week, so we were pretty busy, and that's when I really... Y- you know, did I experience upset clients?

Yep, sure did. But now looking back, right, like the practice was not run well. I'm surprised that it even ran, honestly, with how things were done, and I think there's a lot more resources and ways things are streamlined nowadays. But we didn't have like the Google reviews back then, right? So a client's upset, whatever.

Y- they're upset. They leave. Life goes on. So with the, with that, you know, people can still be upset, and I think they were in certain cases because essentially we're healthcare, right? And I was on some episodes or podcasts recently where I, I talked about this. We are healthcare, which we know is an imperfect practice, hence why it's called practice, and then we take that and mix that with, um, you know, a customer service type business model, so we're providing a service to a customer, but it's done in a way because they're paying for it mostly, right, out of pocket, that th- I think there's definitely a double standard there.

They expect a certain level of care, and to their point, sure, yeah, I think you... we don't wanna pay for something and get not the right amount of care back, if you will. But they don't know necessarily, the average client, like, was that the best use of my money? Was that the best value for my money, right?

And I think this is where we get a lot of people that are upset. I just saw something the other day online, I didn't even read it 'cause I didn't wanna be pissed off, but it was a person complaining that they brought their cat to an ER vet, and it was $2,000, and it was constipated. I'm like sure, that's one way to look at it, right?

Did it include fluids, lab work, maybe an X-ray, an enema, sedation? You know, like, it's not like we gave the thing a fucking Dulcolax and sent it on its way, okay? So their perceived value is where I think there's a disconnect.

So way back when, even before I got into the profession, I think that a lot of professionals in many different professions, doctors especially, were seen as there was that feeling of, I don't wanna say, like, you're better than everyone. That's not what I'm saying, but there was a lot of respect for the profession. There was a lot of feeling that oh, okay, y- sure, Doc, whatever you say. We'll go with it, right?

And geez, that made vet med a lot easier back then. And yes, they were still paying out of pocket, but there was such a respect for the profession, and even for what pets meant to us, I think probably factored into that, too.

So then we kinda move on through the years, and we are converging between that same business model of, sure, a veterinary hospital is a business, and it has to make money. Like, believe me, I don't think that we should shouldn't, you know? I think that we absolutely should. But we are still working from that same model of, like, how do I make this person happy?

And then we're working against all these other external influences that we have zero control over. However, we allow those things to dictate if we're a good doctor or technician or manager or owner, and we allow that to be the compass that we kind of decide, like, am I doing a good job?

So what has happened as time goes on, and yes, there are some clients, they have pet insurance, and, you know, that's great. Most of them pay out of pocket, a vast majority, so they're still feeling that and hoping that they get reimbursed. So there's still kind of that exchange of money.

So what has happened is now, I think, as time has gone on, there's more stuff online, the trust factor in general has gone way the hell down. And this is for many professions, right? Because we feel like, oh, if I can just go Google it and look it up, then this is the same, so you should know all this stuff and more, and I shouldn't have to pay for it, right?

To put it cut and dry, even though we know it's not cut and dry like that. So it becomes this sticky transition here of, okay, I'm paying for a service. Now you are giving me this service, but if I don't feel like I got the value of it, now I'm mad.

You could have done everything right as a doctor, as a technician, on a fucking nail trim, right? Who has been there before, right? And then the client gets pissed because you didn't do the fucking nail trim right.

My favorite, by the way, you can use this one, is when people complain, I'm like, "Oh, yeah, no, okay. You can absolutely do 'em at home."

"Well, I can't do it at home."

Exactly. That's why you're paying us to do it. Okay? So moving on.

It's that perceived value of the perception itself is taking precedence over the medicine and our capabilities.

 

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[00:08:00 - 00:15:00] Google Reviews, Perception, and the Cost of Prioritizing Client Happiness

So then we add in, right? We talked a little bit about the Google reviews. We add in these Google reviews. Now, I think in theory they were maybe meant to be beneficial, and now they've completely gone above and beyond what is beneficial, I think, because do I look at Google reviews for a service or a place that I'm going?

Yes. Sometimes. Depends on what it is. Depends on how important it is. Do I take it with the largest grain of salt? 100%.

Because I don't know about you, but I can read a Google review if someone gave them one star, and just the way it's written, I will stop reading it 'cause I'm like, "This is just an angry person that's venting."

Maybe some of their claims have basis, but the way they did this, I can't gauge whether this is someone that always does this and complains or this is a valid point.

Conversely, how a business responds to those Google reviews I think is hugely important, and my take on that is we should absolutely respond, because if we're gonna do the whole fucking customer service bullshit, we might as well respond the same way.

And coming back, like we don't have HIPAA, right, in vet med, but I also think you can give details that don't tell all the specifics of a case, but also give people clarity.

And when you can do that through a lens, like if you've ever seen these on social media, I know a lot of our vet Facebook pages, people will sometimes post as a business what they replied back, and I'm like, "Goddamn, that's good," right?

They're coming back, they're rooted in facts. It's straightforward, it's neutral. They're not angry. They're not people-pleasing. They're just like, "Here are the facts."

And when I read that as a consumer, I'm like, "Okay, now I can make that determination," right?

Whereas if they're replying, and granted, you can be pissed, okay? But I just don't think it has as much weight when we're pissed off. Unless you do it really tactfully and it's well-written, go for it, but many times there's like no periods in the sentence. You can tell someone's just rambling on, and that's on both sides.

So that's fucking Google reviews, right? That's how we're gonna rate if someone can spay my dog, is how well that Google review is written.

So I just want you to think about that for a second, and I know you're listening to this saying, "That's nice, Amber, but my place of work really looks at Google reviews and puts a lot of weight into them."

Great. Good for fucking them. You don't have to as a human, okay? And we're gonna talk about what that looks like and how to do that.

But Google reviews I think, and just reviews in general, I shouldn't... you know, it's not just Google, but in theory, like okay, sure, you wanna improve your business, but now it's just a way of like how do we get to as close to five stars, dilute out the shitty reviews just so people see us that we're close to five stars?

And I don't think that that's gonna be the greatest determining factor, right, of like who is actually good at their job.

What drives me nuts is like I see these big companies, and this isn't in vet med. This is just in general.

And actually, no, I'll give you a great example. I went for my yearly mammogram, fun times, when you turn 40 last week, and it is a large healthcare company in Florida, and they have, I don't even know how many hospitals, many.

And it was a great experience. Honestly, the people were great. Everything was streamlined. They were organized. I've been there before several times. No complaints. It was great.

And then I get an email, you know, a few days later of like, "Here's a review. Tell us how we did."

And I'm like, okay, most of the time we know that unless someone's really pissed, if they had a good or neutral experience, they don't say anything, right?

And I try to, if I really know that maybe this is based on a commission or something, and someone did a great job, absolutely, I have no problem giving a great review.

But it drives me nuts because it almost just becomes like part of this, "Oh, we should collect this information, and now what do we do with it?"

Because a lot of these businesses, I'm like, "Save your fucking money sending this to third parties to collect this data. Why don't you put that towards training to train your employees and put your money into them to have it, A, be a great experience for your customer, but also put that support into your employees so that they want to stay, and they feel validated, and they feel valued," right?

I can't imagine how much money they spend on these third-party companies, or just in general, even if it's in-house, on how to take these reviews and what do we do with them.

Because I've had some. I was so pissed I wrote a shitty review, never heard anything back. So what do they do with that? I don't know.

But that's what we're doing in veterinary medicine. And again, I think it came from a benign place, but let's look at this as a whole. And I don't think that we can truly judge how a client perceives us as being the end-all be-all of how we are in our jobs and careers.

So I'll give you a good example. One of my coaching clients I'm working with, she works at a hospital. She's a fabulous doctor. And we were talking. She is relatively newer to this hospital, and they were really, they still are, pushing Google reviews.

And like every client they talk to and interact with, they're like, "Make sure you put us on a Google review."

And so she's like, "We have a lot of great reviews. I think they're probably close to five stars."

And she's like, "But, you know, I see the back end of it and all the shit storm of stuff that we could be doing better."

One big huge part of that is there is no training program for their support staff. So she's left with trying to do a lot of those technician duties just for the sake of time, and trying to now teach the technicians a little bit as she's doing that to benefit them and benefit her.

But I'm like wow, yeah, so people are gonna go to this practice just 'cause there were so many five-star Google reviews.

Is that a good determination of that? No.

And there's another doctor that she works with that gets great reviews and isn't really the best doctor, right?

So it actually very much irritates me, and there is... I've seen it both with private and corporate. This is a corporate practice, but I've seen it with both.

And I get you wanna get a pulse of what's going on, but are we gonna have negative ramifications and repercussions if you get a bad Google review as an employee? I think you're not focusing on your employees.

You're kissing ass, so to speak, to make your clients happy so that they tell more people to come, but meanwhile, you can't fucking keep your employees because they're fucking miserable.

 

[00:15:00 - 00:18:45] The Problem With Prioritizing Reviews Over Staff Training

she's left with h- trying to do a lot of those technician duties Just for the sake of time, and trying to now, teach the technicians a little bit as she's doing that to, to benefit them and benefit her, but I'm like, wow, yeah, so people are gonna go to this practice just 'cause there were so many five-star Google reviews.

Is that a good determination of that? No. And there's another doctor that she works with that gets great reviews and isn't really the best doctor, right? So I just it, it actually very much irritates me, and there, there is... I don't... I've seen it both with private and corporate. This is a corporate pr- practice, but I've seen it with both.

And I get you wanna get a pulse of what's going on, but is that... are we gonna have negative ramifications and repercussions if you get a bad Google review as an employee, I think that is there's just... You're not, you're not focusing on your employees. You're kissing ass, so to speak, to make your clients happy so that they tell more people to come, but meanwhile, you can't fucking keep your employees because they're fucking miserable.

So the... I don't think that that is, like... Again, we're going back to the service-based business model. It's not beneficial. So I w- in doing research for this episode, I came across... Because I've always thought this, right? The customer service thing, I've always thought that this was not... it started out in a okay place, but I think because clients pay out of pocket, they feel like they need to get that experience, because let's be honest, let's see the flip side of this.

On the human healthcare side, who's waited in a doctor's office for over an hour, and maybe no one came out to give you a heads-up of what was going on. No one apologized. No one even acted like you actually waited, and you get in the exam room. You spend five to seven minutes with the doctor. You get your prescription that doesn't solve your underlying problem.

Don't even get me started. And then you're, pushed out the door. No fault of the doctor, honestly, because this is, I think, the outcome of a lot of corporate in veterinary medicine. They've done it to the human side, and that's what it looks like, and then they're coming to the veterinary side. But y- would you have a bad Google review and say they're a bad doctor?

Maybe. But no one's like... I'll be honest, I've never looked at Google reviews for doctors because they're so... No one, for the most part, is gonna go out there and seek a bunch of reviews. Now, dentists, yes, I have seen that. Um, I will say my dentist is phenomenal, and They have asked for Google reviews, but they...

Listen, they're amazing.

 

[00:18:45 - 00:22:10] Why Comparing Veterinary Medicine to Hospitality Is Dangerous

But anyway, so it just goes to like people go to that office visit, then they finish, they leave, and maybe they're pissed, but they don't really think twice. And the doctor just keeps going on with their day, right? But on the vet side, we're so consumed with, "Oh my God, what if they say something bad?

What if they put it on social media?" Which we're gonna talk about that too. But on the human side, we're like eh, paid whatever. I don't know, $25 copay. All right, this is annoying." But, we just assume, we got so numb to this is what healthcare is on the human side, now I'm talking about in the US, then we're like, "Whatever."

But if you just paid $150 to spend five minutes with the doctor, now you're pissed, right? Because you're, it's that perceived value. So anyway, in my gathering of information to do this podcast episode, I came across this article. I'm not gonna tell you where it is, 'cause you've heard of this, um, it's a very well-known, it's not, it's not a bad one.

There's a lot of good stuff here. But this article is from 2018, and it was someone that wrote it, and I can't really determine what their role is. They're not a doctor. I don't know what their role is. They don't have any credentials in here that I can see. But essentially they're saying that this was given at a conference.

I think this talk was given at a conference. They're saying that we should look at i- the, you know, customer service essentially. We should look at, for example, the Ritz Car- Carlton, the hotel, the very five-star hotel, amazing hotel, right? Are you fucking kidding me? Okay. This drives me insane. I get it to a certain degree, which I will also go into, but the rest of this article also compares other businesses.

So like, here's what L.L.Bean does, here's what Southwest Airlines does, here's what Lego does. Are you serious? Come on. I get there can be similarities, but just full stop for a second. We are comparing an animal's life, which every single one of us listening to this podcast loves, right? My pets are my life, and whether that's right or wrong, I don't care, and we're comparing how much and how well they get taken care of to a Lego?

You've got to be kidding me. This infuriated me. So, and granted, this was 2018. I hope that this wouldn't be so tone deaf nowadays.

 

[00:22:10 - 00:26:05] Where Customer Service Helps and Where It Goes Too Far

So I'll go into a little bit of why, it is important, okay? You would... I would be wrong to say like- If I went into exam room and I had a client who was so nice, didn't complain, wanted to learn about their pet's condition, wanted to be preventative and proactive, and they're, like, listening to you and just

You know, like, I fucking love that. Don't get me wrong. I could do that all day, and we know that not every client that comes in is like that though too, right? But I love to, like, give resources and, you know, I used to be like, "Hey, this paper one time showed this," so, you know, and try to incorporate that into our discussion so they can make up a very good, decision about their pet's healthcare.

That is great. I don't think there's anything wrong with making that connection and being that person, that go-to person, right, for the client, and being like, "Well, you know what? Let me ask my vet first." Excellent. Form that, that relationship. I love that. I think there needs to be communication. I think there's a, there are a lot of things that happen where communication broke down, and it was neither party's fault, but it ended up being this whole big fucking thing that it didn't need to be.

I do think there's benefit of having ... doing that better, right? But I feel like we've gone way too extreme on the customer service point where we forget our employees and our coworkers and our colleagues. Because let's be honest, if we don't have ... Yes, if we don't have clients, we don't have a business, but if we don't have coworkers and colleagues, it doesn't matter how many clients are coming in the door, we also don't have a business.

And I keep seeing this over and over again, and many of you that I work with are ... That's your stress, right? That's what you're experiencing. So okay. Oh my gosh, I could talk all day about this 'cause it drives me crazy. Anyway so anyway, that article is really mo- modeled after hospitality. It's ... And essentially, if we're modeled after that and that's what our focus is, we are doing this from a customer service perspective s- where the product is actually the experience of the customer and not the healthcare of the pet, right?

'Cause if we work really hard at customer service, then the customer's happy, and we assume as a byproduct, then the pet is well. That's kinda fucked up, right? I know though that I've had cases where I have experienced where I did the best for the pet, and I know the pet was better for it, but the owner was pissed.

And I'm like, I u- that used to eat me up inside. Now I'm like, "Psh, that do- that dog's doing better. I don't care." And it is what it is, right? The worst too is then you Do something where, a client perceives something as bad or not good or not standard of care or whatever, and it's like something that everyone does, and you're like, "This is...

We all do this. Why am I the one that you're, you know, jumping down my throat?" So really, the, the focus has shifted, and it's more on as veterinary professionals are explaining or justifying... Now, explain and educate all day long, absolutely. The justifying and over-explaining is coming from a place of like convincing and trying to get that client to not just understand, but now essentially try to justify what you're recommending, and especially with the price that's there, too, right?

And it's less about the clinical decisiveness, trusting your training, and we have to now... We're focused on making the client happy, God forbid, you know, and hopefully the pet gets better in the whole grand scheme of things.

 

[00:26:05 - 00:30:00] Boundaries, Burnout, and Taking Back Control

So what happens with this, too, is that we get cognitive overload. So we're constantly just like tracking what we say, how we say it, how this could go wrong, how we could be perceived incorrectly.

Add in if you're neurodivergent, who already find this challenging on a good day, and who many tend to mask. Essentially they're showing up as I did this so- for so long, right? I showed up as like, "Oh, yeah," like, "Let me help you," and this and that. And, and they, they could be yelling at me, and I'm still doing that, right?

'Cause I'm people-pleasing, and I, I just learned that, that conflict wa- wasn't comfortable and that I could people please my way to get them to agree with me and then not be mad at me, okay? That's the difference. So add in, yes, if you're neurodivergent on top of that, you're masking anyway. You're doing that on a regular basis.

This is just at a totally different level. Another thing that w- I was talking recently with a coaching client was that we don't... I know some practices do, but it is not commonplace to charge a late fee if a client is late or a no-show fee, w- however you wanna do that. And when we were talking, she's like, "Yeah, the older practice owner is like, 'Oh, no, no, no, we can't do that.'"

And I would be like, "Why the fuck not?" Because here's the thing, you're worried about pissing off a client that's gonna go to another practice. Well, first of all, do you really want them in your practice if they don't value your time to show up on time? They're gonna keep doing that. There's no repercussions.

And we're letting people for a 30-minute appointment come 20 minutes into the appointment. We're gonna jam you in here. I have a full scheduled day of appointments- And now I'm gonna have walk-ins on top of that, or people call and their pet's stable but sick, maybe it's got an ear infection. "Oh, sure, come on down."

And we're just overloading the schedule 'cause we can't fucking say no to anyone because we worry, number one, yes, it's a business. I get that. There are ways, just so you know, I work with my clients, there are ways to structure your scheduling that allows for that, so you don't have to say no to these people.

But it's almost that feast or famine type of mentality, and it's the scarcity mindset that if, "Well, if I don't take 'em in now, then they might go some other place." Well, fuck it, okay? Your good clients are the ones that are like, "Dude, I know you're busy. I so appreciate you fitting me in. I'll be here.

I'm sitting in the lobby, no rush. Like, you do what you gotta do." Those are the people that you want, and that's where customer service is great, but we have taken it too far, I believe, where we're catering to those clients that aren't very nice or respectful, and we are teaching them that it is okay to treat us like crap, right?

Okay, what are the consequences? Number one, consequences are gonna look a little bit different for everyone 'cause everyone, handles things differently. But we tend to then, we're overthinking, we're overanalyzing, we're taking on more responsibility than is our own. And this trips people up a lot because clients do have a responsibility, and many...

Not many. Some of them don't wanna take that responsibility. They're not aware that that is their responsibility. Is it our job to tell them? Depends on the case, right? But when I work with coaching clients they're like, i'm like, "That's not your decision to make. You gave them the information."

They're like, "Yeah, but they're mad that it's gonna co-" I'm like, "Then that's them," you know? That is on them to be a responsible adult and make their financial decisions based on their financial situation. You have questions about how to do that, and if there's assistance, absolutely, we will help you with that.

But to own that, y- they're mad because the lab charged X, Y, and Z, and you have to charge that to the client, no, that's not ours to own.