Archives for category: Veterinary

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I know this is difficult
Because it is difficult for me too.

I know you are scared
Because we are all scared.

I know you are tired
Because everything is harder.

I know you are frustrated
Because what should be simple is fiendishly complex.

I know you are wanting this to end
Because the end is not in sight.

I know you want to get back to normal
Because normal was awesome.

I know you are glad to be busy
Because the alternative sucks far worse.

I know you value your teams
Because we all feel the same way.

I know we can do this
Because we kick ass on a daily basis.

 

Written as the introduction to a staff meeting.  

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The Vice President, Mike Pence, toured the Mayo Clinic, without a mask, in the middle of a pandemic.

When questioned by reporters as to why he was not wearing a mask in line with hospital policy, a policy that the Mayo Clinic stated that Mr. Pence was aware of in advance in a now deleted tweet, the Vice President stated that he is tested regularly as are those around him and he wanted to be able to “look people in the eye.”

Footage of Mr. Pence’s visit can be seen below.

Later that same day, a question was posed on Quora (where I spend an inordinate amount of time) that got me thinking.

Why didn’t someone in authority at the Mayo Clinic stand up and tell Mike Pence, “If you don’t wear a mask, you are not entering this hospital.” Should that person who was in charge on that day be fired for failing to protect the patients?

A fair question, but one of the reasons the question gave me pause for thought, was that I had faced a similar dilemma a couple of days earlier.

Like most veterinarians, the animal hospital I am Hospital Administrator for is operating locked down – with clients being made to wait in their cars and only patients and staff allowed in the building. In addition, all staff have their temperature taken before entering the building and wear a mask for their whole shift. That policy worked just fine, until the day a client walked into the lobby and refused to leave when asked by staff members.

I was called into the lobby by one of my front desk supervisors. When I arrived, the unmasked client was defiant and refused to leave the lobby when asked multiple times. The client was upset that her dog was sick and currently hospitalized. She felt that it was too hot for her dog to be brought out to her in her car for her to visit with, and therefore was demanding entry to see her dog. I explained that I knew nothing of the situation, and that I would be more than happy to help in whatever way I could, but none of that was going to happen until she left our lobby and returned to her car.

I have had to ask clients to leave the premises in the past, and I have even had to call police to make it happen. As I was talking to this client it was running through my head that I might have to do this again, or at least threaten to, to protect the doctors and staff. However, it was also running through my head that we had a hospitalized patient who was in the middle of treatment. Could the forced removal of a client from the building be interpreted as denial of care? It is doubtful that the client is going to continue their pet’s treatment at our hospital if the relationship breaks down to this point. What happens to the pet? Is the pet well enough for an orderly discharge? What happens if the pet dies either directly, indirectly, or just shortly after being discharged?

All of this with raised voices in the lobby, out of the blue, with no time for refection or the advice of others.

Now, as it happens, the client did return to her car and a quiet chat with the doctor, car side, resolved the immediate issue. But what if we would have called the police and had the client removed from our property, her pet discharged before being even close to well, and things had continued to deteriorate? Review and social media warfare for sure. Local news and / or regulatory involvement? Quiet possibly.

Upon reflection, I would do the same thing again and I actually feel more than ever that even if I had ended up calling the police it would still have been the right call. But I’m sure others would have disagreed. And some of those may have been people that I report to – including the staff it was my aim to protect.

I don’t run an organization anything like the size, or complexity, of the Mayo Clinic and one can’t imagine what it must be like to hold that position, in human healthcare, in the middle of a pandemic. Having a dignitary like the Vice President means national news coverage. It is the kind of publicity that public relations departments were created for. It could mean government dollars, PPE, and access; all of which are sorely needed right now.

If, of course, it goes well.

If it goes wrong, all of that could be in jeopardy and a lot more; The reputation of the Mayo Clinic in the eyes of half of the electorate, for example. As Mike Pence has stated, the risk from him is probably minimal, given the protective bubble he currently finds himself in. The example that he sets, however, is awful. It is an example of “the rules don’t apply to me” because of XYZ – much like my lobby client.

I cannot condemn the administrators at the Mayo Clinic though. Standing up to people because it is the right thing to do, can have serious consequences. Embarrassing the Vice President of the United States would have had serious consequences for the hospital, the staff, and the administrators. Being right is not always a defense from consequence. To make that kind of decision in the heat moment, is an almost impossible. And it is certainly impossible to make it and to not double guess yourself.

The issue reminds me of the incident at University Hospital in Salt Lake City where nurse Alex Wubbels was arrested for not going against a policy agreed upon between the police and the hospital. She would not provide a blood sample without the consent of the patient. The clip below shows Nurse Wubbels on the phone with the hospital administrator, and the police officer concerned, right before her arrest. The arrest of Nurse Wubbels was national news.

All decisions have consequences. In the Alex Wubbels case, the arresting officer was fired, and his supervisor was demoted two ranks. The City of Salt Lake also settled a lawsuit for half a million dollars. But this took serious guts on the part of the hospital, and of course Nurse Wubbels. It would have been so easy to bend the rules for people who you work with routinely, want and need to have a good working relationship with, and even been seen as doing the right thing in many corners.

Being right can often be a balancing act. Second guessing decisions made in the heat of the moment, particularly when confronted by authority, or just someone who is confrontational, is often unhelpful. As managers, we have to fall back on integrity and the momentary weighing of risks.

But the balancing act is rarely black and white.

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Routine.

We have routine.

“Good morning “while waiting for the thermometer all clear.

The snatched moments of laughter – less than before, but not gone altogether.

Some days are busy, some days less so.

But the days have less form than before, less shape. Less to keep them in memory. Less to measure them by.

We can measure time in policies and protocols that have come and gone. Some that we never used at all. And some that may still need to be dusted off.

Lets hope not.

Businesses that have a healthy culture see this culture bear fruit, and weather the storms, disagreement, and fear.

Businesses that have culture problems are finding that now it is too late to try and fix it.

Crises act like a magnifier. Just what you had before only more so.

Like all situations there are rarely heroes and villains, the world is more complicated than that. There are heroic acts and acts worthy of villains.

The fractures in teams, departments, and relationships are tested. How resilient we are, depends on the history we have; good or bad.

Managers and leaders, have a new appreciation of the J.K. Rowling’s Snape; doing wrong things for the right reasons; being perceived as the bad guy, and shouldering that burden silently, when so much is about survival and the greater good.

But all of this is fine. We are okay.

In that awful phrase, over used and misunderstood; this is the new normal.

This is us digging in for the long term.

Reassuring clients over misleading headlines.

Addressing customer service issues like the old days.

Accepting praise where we can get it.

Ignoring Yelp reviews – because.. really?

Creating a social life by computer.

Valuing connections like never before.

These are people I choose to go through a pandemic with.

These are the people I will get through a pandemic with.

 

*Apologies to Dr. Michael “The Harry Potter Vet” Miller for appropriating his Snape analogy. You can check out Michael’s work on Instagram: @harrypottervet

 

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Ten Days.

It’s been ten days since we stopped allowing clients into our building.

I could not believe it today when I made an updated client blog post, you can read it here if want, that it had been ten days since the last one.

It feels like three days ago.

The days have melded together.

We are getting into our stride, and everyone is adapting.

Some genius (not me) suggested numbering our parking spots and marking them out in chalk. Someone else suggested papering basic instructions and our phone number on our windows.

But at home it all melts into one.

Again, I’m still very lucky. I’m employed and well. I have a vaguely normal schedule. I’m not on the front lines, even in the veterinary world. Its more, so much more, than many.

But I can only decompress and try to relax, or go back to work.

I’m either on or off. There is no middle ground.

It’s grief.

That’s the only word I can find for it.

Grief for the dog park.

Grief for dinner with colleagues or friends.

Grief for home projects, for which I always have had boundless energy.

Grief for Hockey, I miss my Golden Knights.

Grief for meeting with my team, usually the highlight of my working week.

Grief for my town, everyone else’s playground that I call home.

Grief for how things used to be.

I am so spoiled.

My loss is measured in an unwillingness to do vaguely productive things with my free time.

Until my friends start to get sick, as one did today.

Until my friends tell me of clinic owners wanting to cut their losses and sell.

Until my 90-year-old Mom starts off our weekly transatlantic phone call with “I’m not sick.”

Until the worry, fear, anger, frustration, boil over into words.

It’s been ten days since we stopped allowing clients into our building.

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The worst week of my working life.

I’m sure it is the same for a lot of you.

I’m lucky.

We were prepared.

We had a plan.

We are open.

I have a job.

I am well (so far).

But I am pretty beaten.

The constant planning, changing of the plan, and then changing again.

Messaging to staff and clients, much of it contradictory, from day to day.

The difficult conversations; “it’s not enough” through to “it’s too much.”

The constant conversations, decisions, and monitoring of decisions.

Getting into work first, and leaving late.

Snapping at people who are just trying to keep things light and being their normal upbeat selves. Or whom are not as quick at checking their email as you would like.

Trying to enforce social distancing.

Seeing the town I love, and I’m proud to call my home, look like it is dying.

The constant, ever present, worry about colleagues, friends, and family.

I am not ashamed to say I cried at my desk yesterday.

But I did not cry because of all of the above. I cried because I as posted that we would be cutting our hours, not letting clients into our building, and fearing, as I have for weeks, for what is to come, a client responded:

“So typical of Craig Road, they care about their patients, and pet parents. ❤️”

And what I thought about is my colleagues.

The team I work with.

The ones who have done everything they can to help prepare, implement new policies, and new cleaning regiments. Who have been dedicated to ensuring we had the basic supplies we need to be there for our patients. Who accepted daily temperature checks like is was the most normal thing in the world. Those who have had really bad days and still are at work, and want to work, to look after our clients, and our patients.

My Team.

The internal culture of workplaces can be a fragile thing. But it can also be resilient. They can even thrive in adversity. People check in on other people. Making sure that their colleagues are OK.

Making sure that I’m OK.

The stuff of nightmares, does not have to be a nightmare.

Undoubtedly, the worst is yet to come.

We will get through it.

Things will be different.

We will have changed.

But we will also have grown, and we will have our teams with us.

Stay safe.

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Photo by Andreas Fickl on Unsplash

What is common sense?

Is common sense to a manager the same as common sense to a veterinarian? Or to a veterinary technician? Or to a customer service specialist? Or perhaps, most importantly of all, to a client?

Common sense should be knowledge that we all share; however, it is rarely used that way. It is often used as a bludgeon on people for not reading our minds. Common sense is short hand for “you don’t know what I know, and I think you should.” The problem is that we rarely recognize that our own common sense is more often than not a point of view with some additional specialized knowledge.

Chip and Dan Heath in their book Made to Stick, talk about the “curse of knowledge.” They outline a simple experiment conducted at Stanford, where by a number of “tappers” were given 120 well know songs to recite using just knocks on a table. “Listeners” would then have to guess which each song was. The Listeners were right only about three times out of 120. What was extraordinary; however, was that when the Tappers were asked whether the Listeners should be able to pick out the song, they replied that they should be able to 50% of the time! The Tappers felt they were being understood more than 47% more than they actually were. The Tappers were hearing the song play along in their heads while tapping it out on the table. The Tappers had knowledge that the listeners did not, and so dramatically over estimated the Listeners ability to recognize the song.

Common sense is a side effect of the curse of knowledge. A team member who may excel in looking after an unhappy customer, or preventing a customer from becoming upset in the first place, may not automatically understand the seriousness of a cat that is straining to pee. Likewise, a veterinarian may not understand the reason why their client is not being immediately shown to an exam room is because of the 12 other people that just walked through the door that the customer service representative is trying to deal with.

Now in both of the above examples, training, proper protocols and procedures, and a commitment to teamwork should solve all of these issues. But when we fall back on common sense, or a lack of it, we are doing a disservice to our team members and even to ourselves. If we replace “common sense” with the words “knowledge and experience” in the phrase “you have no common sense when it comes to dealing with clients” the person at fault switches from being who the phrase is directed to, to the person saying the phrase.

Give it a try – I’ll wait.

Common sense is an excuse for leaving training and continuing education to osmosis. It has no place in management, and really has no place at work at all. Employees are not going to place themselves in shoes of clients without being trained to do so, and they rarely have the knowledge to place themselves in the shoes of managers or veterinarians. Common sense is lazy, overly broad, and does a disservice to the person using it and the person whom it is directed against.

It is time to recognize it for the dysfunctional symptom that it is.

In this ongoing series we look at ways of preventing employee theft. In part one we looked a cash handling methods, in part two we looked at credit card theft, in this part we take a look at best practices for preventing theft from inventory, and in part four we look at time theft.

As with credit cards, and particularly cash, inventory control and theft prevention are a matter of sensible precautions, double checking, and never allowing any one person too much control. Video cameras are also a prerequisite for any kind of inventory theft protection. The deterrent factor alone makes them a worthy investment. It is important to consider placement with video cameras, however, and to consider this when placing items in storage that are more likely to be stolen.

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Image courtesy of Pixabay

Risks

Identifying the high-risk items that desirable to a thief is an important first step in any prevention strategy. What makes items desirable to a thief? High value, small size, and / or easy to sell or use themselves. In a veterinary practice, controlled substances would be at the top of this list for obvious reasons, but pet food and treats would also make the list as they are routine supplies for any pet owner. Any establishment that sells alcoholic beverages, needs to consider just how easy, and desirable, it is to steal them – particularly hard liquor. It is informative to walk around your local grocery store and check out the different levels of security in different items and then apply those to your own business. Alcohol, of course, has additional measures in place in a grocery store, but so do razor blades (due to their expense and small size) and movies (due to their small size and ease of resale.) High risk high value items should have significantly higher levels of security and scrutiny than other items. That means that only key people will have access. This will make things more complicated for their handling, but the alternative is no security at all.

Certain items are always at risk of theft due to their ubiquitous nature: toilet paper, stationary, and cleaning supplies. Keeping an eye on reorder quantities is really the only way to ensure that a problem with theft is not missed; however, just watching the cameras on the employee entrance/ exit can often be enough.

Businesses that have significant issues with employee theft, will often ask to look in employee bags before as they leave the premises. While this can seem overly intrusive, it is important that your employee handbook contains language to make this a possibility if required.

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Image courtesy of Pixabay

Ordering & Receiving

Ordering in any business needs to be controlled. The person that is responsible for ordering, should not be the same person who is responsible to receiving goods and ensuring that what was ordered has indeed arrived. In addition to having multiple people involved, there also has to be a paper trail. When an item is ordered, the order has to be logged through a purchase order record of some description. When the item arrives, it should be received by someone other than the person who ordered it, the packing slip should be signed off on (or a packing slip created if the goods did not come with one) and then forwarded to accounts payable.

The packing slip should be matched to the purchase order which it turn is then matched to invoice. When things are paid for by credit card, it should be indicated on the purchase order, and then the credit card bill should be reconciled against packing slips and purchase orders.

The above may seem over the top for most small businesses, but the question that has to be answered is what is to stop an employee ordering an item from a supplier, destroying any paperwork, and taking the item home? Is your accounts payable person, assuming that they are not the same person who has been ordering, going to be able to find that one uncounted for item in amongst everything that is ordered when a supplier’s statement comes in weeks later?

On a side note, it should be made abundantly clear to all involved with ordering and receiving that “free product” or “gifts” from suppliers belong to the business, not to whomever receives them. There is sometimes the impression that because items have not been ordered, or have been nominally given a $0.00 value, that they are free to anyone who wants them. This cannot be the culture in your business.

Items which arrive outside the hours when they can be received properly, and by the appropriate members of staff, should be locked away unless there are serious reasons why they should not be (items that need to be refrigerated for example.) This prevents well intentioned, but misguided attempts to “help” and also more nefarious outcomes. It also prevents the frustration of knowing that an item is in the building but being unable to find it due to it being put away somewhere other than where it should be.

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Image courtesy of Pixabay

Stock

In order to sell products, employees need to have access to those products. That does not mean; however, that all employees need access to all products, at all times. A limited amount of non-high risk non-high value items should be placed on employee accessible shelves. Your main stock should be under lock, key, and camera. The inventory manager, or a supervisor, should be the only one who moves stock from one location to another. For high-risk high-value items, senior members of staff should be the only persons who can have access, and they themselves should have a strict protocol (a log book at minimum) which they have to follow when retrieving an item.

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Image courtesy of Pixabay

Counting

Inventory has to be tracked. If you order 10 widgets and have 5 widgets in stock your inventory system should be able to tell you that after you have received your new widgets that, yes you can fill that order for 15 widgets.

The reality, of course, is rarely that simple. When it comes to inventory control you get out what you are prepared to put into it. An accurate inventory management system, where you can spot that five items are missing almost as soon as they are gone, only happens through hard work and effort. Good systems that are easy to use will work well, but they have to be maintained and repaired. Not just so that the system is correct, but so that the faith of employees, and managers, in the system is maintained.

High risk items should be counted once or twice a week. Discrepancies should be resolved or reported. All inventory items should be counted once or twice a year and the running count in the inventory control system reset. Constant shortages should be investigated as to whether it is shrinkage (theft), orders in process, or the mis-selling of items.

This level of effort put into inventory control can seem expensive and wasteful; however, you cannot track what you do not count. And you cannot know what is going on with inventory unless you count it.

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Image courtesy of Pixabay

Auditing

In addition to counting, there is another way to see if items are walking out of your premises and not being accounted for. At the beginning of the year you bought 100 fidget spinners. You look up the invoice from Fidget Spinner Inc. and confirm that you were billed and paid for 100 units. At the end of the year you have 10 fidget spinners on the shelf. You run a report from your sales software on how many fidget spinners you have sold. Hopefully, it says you have sold 90. But what if it says you sold 80?

The inventory control side of things says that there should only be 10 in stock, which there are, but you have not sold 90. The problem could have been in the number that were received originally from the supplier, or whomever received them, or someone with access to the inventory control system has manipulated the system to make it appear that 10 fidget spinners are not missing.

You’ll notice in the above example, that it does not rely on inventory management to find that there is a problem; but it does allow for the problem to be narrowed down. This can really only ever be used for spot checking, but it does provide a backup system to the general inventory control system.

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Image courtesy of Pixabay

Employee Sales

Sales of items to employees can be tricky to navigate from a theft prevention standpoint. An employee leaving the building with a bag of dog food from the vet’s office looks identical to an employee stealing a bag of dog food from the vet’s office. Having a strict protocol in place for sales of items to employees so that all items can be accounted for is essential. Do not allow employees to process their own transactions; there is just too much opportunity for issues to arise. All items should be billed for at full price and then a senior member of management should handle any discounts.

Inventory can be difficult at the best of times. Employee shrinkage; however, can be a serious problem and significant inventory controls will not only serve the needs of the business, but protect it from those should have its interests at heart.

Next week we will look at Time Theft.

The following is a short talk I delivered at the Uncharted Veterinary Conference in April 2018 as part of their Mic Drop Series.

How valuable is experience when it comes to leadership?

Should we value experience?

Is it a benefit or a hindrance?

So let’s define some terminology…

A leader is someone who is followed.

A visionary is someone with an idea or ideas.

And a manager is someone who makes things happen.

All of these can be combined, or not, depending on a persons personality, experience, or skill set.

Some examples of Visionary leaders…

Steve Job of Apple,

Elon Musk of Tesla and Space X,

Jeff Bezos of Amazon.

Visionaries who have, literally, changed the world.

they are all looked up to and considered gods of technology. People regularly compete to work for these people and to work on those products.

They also all have the reputation for being awful managers of people to the point of cruelty.

If Visionary leaders are horrible managers then what about managers who have vision?

Tony Blair – former British Prime Minister,

Michael Eisner – Former CEO and President of the Walt Disney “Company,

George Lucas – Film Director and former owner of Lucasfilm.

Tony Blair was elected in 1997 on a wave of hope and goodwill, he transformed his labor party in “New Labor” which had been out of power for 18 years. Despite some major successes, Blair resigned in 2007 and labor lost the next election and has not been in power since. New Labor is in ashes and Blair is widely reviled in the UK, and even by those in his own party, for his tone deaf approach to the Iraq war and for his corporate connections.

Michael Eisner led the Walt Disney Company from 1984 and 2005. He revitalized the company in the eighties and nineties with “Who Framed Roger Rabbit,” “The Little Mermaid, “The Lion King,” the expansion of the theme park business, cruise ships, and the creation of stage shows. He ultimately split with his long time collaborator Jeffery Katzenberg and Roy Disney and saw an unprecedented shareholder revolt in 2004 that lead to his resignation in 2005.

George Lucas – transformed the movie industry with the original Star Wars trilogy. Arguably then did more than anyone else to sink it with his widely panned prequel trilogy. He is criticized for having a singular vision and for not listening to the feedback of others.

If visionary leaders are horrible managers and managers with vision ultimately self destruct,what about managers who just manage?

Bob Iger – Current President and CEO of the Walt Disney Company,

Bill Gates – Former CEO and President of Microsoft,

Tim Cook – Current CEO of Apple.

When was the last great breakout product from any of these companies, who are led by these managers, that was not bought it?

These companies are profitable, they make good products, just not great ones.

Why do some mangers, particularly those with vision fail, when managers without vision can succeed?

How come some visionary leaders can break all the rules and still win?

This is my story.

The period of time I’m taking about I’d been in my job for about 4 years.

I knew the answers to all the questions I was asked.

I’d tried most of what is suggested by others and had strong opinions about those suggestions.

The ghosts of what had happened in the past in the workplace haunted my current interactions.

I anticipated the responses of others and therefore do not even try to have new interactions.

I overvalued my own experience.

I believed my own story, my own press.

The things that made me a good manager – a manger with vision, a leader, I now actively rejected since I had the experience to no longer need them.

And the staff, and the people I worked with, pushed back.

I became the bad guy.
I became the roadblock.
I became the one who would not listen.
I became less and less effective.
I became the manger who kept his own counsel on everything.
I was the most capable – but I was he least able.

Some call this burnout.

I call it not learning from the experience of others.

The first step in recovery is to acknowledge that there is a problem.

Interestingly during this time I, the experienced world traveler, for the first time in my life, missed four flights because I knew, knew, when my flights were and that I didn’t need to double check.

Solving this problem is not hard, you’ve, I’ve already been that person. You just need to find them again and be aware of the trap that you are currently trying to climbing out of.

The tools that made you a good manager, a great leader, when you started are the same tools that allow you to continue being so. You just have to remember that the process can be as important as result.

Capability only has value if you have the ability to use it.

Capability only has value if you have the ability to use it.

And it is those around you, those that you lead, that give you that ability. You undervalue it at your peril.

Thank you.

One of my most popular blog posts is “The Cost of Servant Leadership” which I published in 2012. Due to some renewed interested, I thought it would make a nice first choice as the core content for my first experiment into animation. I hope you enjoy!

If you would like to read the original post, The Cost of Servant Leadership, you can find it here.

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