Surviving Radical Vet Industry Changes

In each episode you’ll hear from host Mary Schwartz and passion driven individuals on their ideas, best practices and stories on surviving radical vet industry changes. We will provide you with actionable tips on adopting a CareFirst Approach.

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Understanding a CareFirst Approach to Veterinary Medicine with David Liss and Sam Schopler

One of the biggest challenges the veterinary industry is facing is the commoditization of pet care due to the rise of big-box retailers offering veterinary health services. At PetDesk, we want to identify ways veterinary professionals can improve their best vet self by adopting an approach we like to call "CareFirst".

So often we see the local practitioner up against big chains like Walmart, Lowe’s, or Petco for veterinary care. CareFirst is the mindset being adopted by veterinary professionals that embodies strategic steps independent clinics can take to guide their clients to better pet care.

In this episode, we talk with David Liss, an experienced veterinary management professional with a specialization in all aspects of veterinary hospital operations, and Sam Schopler, a veterinary student working towards his DVM. Together with host Mary Schwartz, CVT they discuss what CareFirst means to them and what tools the veterinary world needs in order to fight back against big-box retailers and commoditized veterinary care in this ever-changing industry.
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Mary Schwartz:

Hey, Sam, why don't you let us know a little bit about yourself and what you're up to these days.

Sam Schopler:

Awesome, thank you Mary. I'm up to quite a bit, I guess. In vet school, also still working part-time for Pet Desk, but overarchingly I think a lot of the time that I spend and the effort that I make in my day to day is towards helping people take care of their pets. I'm involved with a group called VetPartners in the industry, that's mainly consultants that are working to help educate their clients on how to improve pet health. Pet Desk is obviously a company that's very focused on helping providers take better care for their clients in order for them to take better care of their pets. I'm in my second year of vet school, so aspiring to be a doctor, just finished the second year, so I'm at the halfway point, which is a big relief. Outside of that, just try to stay involved in as much as I can, in groups like the Veterinary Business Management Association on the school side of things and whatever conferences that I can get to in the vet industry.

Mary Schwartz:

You've got a little bit of everything on your plate.

Sam Schopler:

Yeah, a full smorgasbord, try to stay busy.

Mary Schwartz:

Yeah, you've got to. David, I would love to hear a little bit more about what you're doing these days, I know that you've got a lot of experience in the industry.

David Liss:

Yeah, thanks Mary, excited to be here. I currently am a multi-site director, I oversee about 11 practices in California, mostly general practices and helping them be successful. I work for AmeriVet Veterinary Partners, and we are a group that focuses on partnership as an exit strategy for veterinarians and practice owners. I have been in the industry... This has been my only job, obviously I have a lot of different jobs in veterinary medicine. I was a technician for a long time, really enjoyed being on the floor, but I've really moved into a new chapter in my career, which is really people leadership. I really, really enjoy working with veterinary teams, pushing them, supporting them, hearing from them, working with them to connect and run really, really awesome practices that provide great care for pet parents and they're efficient and profitable. I appreciate being on the podcast.

Mary Schwartz:

Yeah, I couldn't imagine two better folks to chat with about CareFirst, so let's dive into a little bit of what CareFirst is. CareFirst is the acclamation and mindset being adopted by veterinary professionals that embodies the strategic steps independent hospitals need to take to guide their clients to better pet care and defy the big box retailers commoditization of care. Knowing that commoditization is a huge issue within our industry and we see things like Walmart and Lowe's and Petco bringing in these big chains to take their share of veterinary care away from the local practitioner, how do you think a CareFirst approach or lack thereof affects our industry?

David Liss:

I think you have to really see it as a David and Goliath situation, so independent veterinary practices really are going up a little bit against a Goliath. It's not insurmountable, they can certainly get there, but they have to look at what does the big box chain and what does commoditization look like and what are the needs of their clients that are not being served? One of the needs that I think is served, but in a generic way, is education, and a lot of the big box groups have a lot of education that they'll provide, but it's done in a dry way. It's an email or it's a blog or, social media post, and I think that private practices, individual practices that still really offer that boutique experience that are really bonding with their clients.

They know Mrs. Smith, who's been a client for 30 years and wants to see Dr. Bob, who's been there for some time, can really spend a lot more time in the exam room, going over really all of the parts of care. They're going to want to tackle the diet and debunk the raw food myths, and they're going to want to talk about why dentals every year is really important. Do it in a way where they're really telling the client we know you know, you're not just a number, you're not just a quote unquote customer. We also don't want to usher you out of the room because we have to see 50 more people, we know you, we want to spend the time with you, that's really, really important. It again, kind of gets back to really the roots of veterinary medicine.

As clinics move towards that, you move a little bit away from what I think most veterinarians, veterinary technicians and support staff don't want to do, which is that high volume churn and throughput of get them in, get them out, get them in, get out. That's not why most of us went into the industry, so you end up with really, more efficient, more profitable, actually, and clinics that provide just a really higher standard of care and a higher connection with their patients. If you think about what clients search out, and we have to defend against the Dr. Google stuff, you have to know it's there and it's very easy for all of us to pick up our phones and type in dog vomiting and get a list of things that it could be and then we freak out and we run to the vet.

If you don't counter that with that personal connection of, hey, did you already look this up on Google? Got you, let me talk you through why that doesn't work. Rather than giving into that and succumbing to that and saying fine, you already know what Google says, let's just give you a shot and get you out of here, I think we can really win.

Sam Schopler:

Well in that case, I really appreciate what you said there, David, and a bit of background in my experience, my dad is actually a veterinarian, my aunt's a veterinarian, so I kind of grew up in a clinic a little bit. Then having worked with Pet Desk for the last six years, got to see the technology side of things and the evolution within the veterinary space, quote unquote. One thing that's been really interesting to witness and hear people talk about is not just how the commoditization of pets is happening, but also as we're in this overarching theme of just convenience is king and subscription world that we're living in, how there's also this increase in the personhood of pets. People are paying a lot more attention to their pets, they're paying a lot more attention to what they're giving their pets in terms of food or the toys that they get.

With that personhood of pets, we're also seeing an increase in the amount that pet parents are willing to do for and plan for their pets lives, so that's where I think the small clinic has the opportunity to take advantage of a CareFirst approach. Because yes, as we get into this commoditization, there's going to be an opportunity for people that are maybe their first time having a pet or they don't really know where to go, they're going to maybe find the big box stores a little bit more convenient or cheaper.

But as we see this revolution in pet care on the side of the pet parents, having that experience that David so eloquently outlined of being able to see the journey of your pet with the same professionals and knowing that the care is there from start to finish and being able to really dial in on the specific needs of not just the pet, but of the household of pet parents that are taking those pets into their vet clinic is an awesome opportunity. I think that CareFirst model is something that a lot more people are going to be drawn to as they start to pay more attention towards and plan out their pets' health lives.

Mary Schwartz:

Yeah, I totally agree, Sam, and I feel like us sitting on this side of the keyboard, we definitely know the value of the services that the local practitioner provides. We know what expertise they have to offer and the value of having that same practitioner throughout the life of your pet and what that brings. But how do we educate the public about that? How do we adopt this CareFirst approach and stay relevant and compete in a world where the public doesn't know the difference between Walmart vet and Dr. Bob's local clinic?

David Liss:

Yeah, that's a great question, I think we have to almost go back to where we started in veterinary medicine, where most of the doctors would spend a long time in the exam room going over stuff with clients. We liked engaging in that two-way conversation with our clients about what's going on with their pet, why we're doing what we're doing. I think today's world everything is just so busy and everything moves so much faster that it's super easy to just have a client say my dog's been vomiting a few times and the doctor in his head, or her head, does the exam and real quickly comes up with the treatment plan and then shoves the injection in and says, okay, Steve's going to check you out. The client is going, what could have caused this?

I worked in emergency a long time, and I still work with a lot of specialty practices and have worked in them, and a lot of times the clients are calling multiple times a day saying, I just don't understand what's going on. I understand of course too, that there's sometimes some clients just aren't going to get it, but there's a lot of clients that just say, I talked to the vet for 20 minutes, it was all medical speak, I don't really know what's going on. If you think about the new way a lot of businesses operate is really this ecosystem model, so you've got the product or the service, which for us is veterinary medicine, you've got the people that deliver it, so you've got vets and techs and the building and all the equipment. But they also pretty much, to this day, have an educational component using social media or other digital channels, whether it be email or text or whatnot.

After I go to the dentist, I get a text message right after I leave that says here's a link to some article that I should read about good dental care, and on their Facebook it'll say today's dental awareness month and did you know that X percent of kids don't get access to... They have all of these education things that are feeding that direction. As a millennial, I learn, to be honest, most of the new information after having gone to college from YouTube, I type in GameStop Reddit stock investing and boom, I can watch 50 videos on how to be a hedge fund. You can learn this kind of stuff now, so people can go to YouTube or Twitter or TikTok and type in dog diet, and you're going to have a lot of people, including some veterinarians, that'll say raw food is good and you should never feed them X, Y, and Z.

We've got to counter that wave by saying, we actually believe in whatever, Royal Canin, Hills, whatever diets that you guys stand behind. I think it really has to go back to the roots of teaching education, but we do have to do it in a modern way. We've got to think, talking in an exam room is great and super important, but super inefficient as well because we do have to see a lot of people. Demand is up, pet ownership is up, so we have to think about other ways that we can get our clients educated so that when they come in they actually are asking the questions of us, the experts, rather than thinking that they know what they need already. I think that's a feature of commodity, you walk into Walmart knowing you need lettuce and ketchup to make burgers, we can't have that of clients walking into a vet clinic and saying my dog needs this medication because I saw it online. They need to come in to the veterinarian and technician and say, my dog's been vomiting, what do I do?

Sam Schopler:

I really like that, and it's not in opposition to what you just said, but I think there's this tandem of, we need to be able to supplement that educational material and we need be able to enhance the journey of the client into the vet clinic before they have their appointment, after they have their appointment leading into it. But I loved the idea of getting back to the roots of vet med, and in vet school we're learning from the moment you meet a client until the moment that they depart your clinic, whether it's because their pet passed away or they moved. That entire time is an opportunity to build trust with the client in order for them to see the appropriate way to care for their pet when you don't have them in front of you.

I think that trust is such a huge part of what a smaller practice has to offer. Throughout the pet parent journey, if I am able to build that trust because I have a great experience in getting into the door and I have a great experience with the technician and the team up front, I'm more likely to be compliant on the things that the veterinarian wants me to do in between visits. I think that's a really big piece that may get lost in this bigger conversation about commoditization, because you just aren't going to be able to replace that. When I have been pondering how I'm going to be a different veterinarian than my dad, one thing that I've really come to realize is that the pie slice of information that my dad learned, the percent of vet med that he came out of school with, the knowledge of, is much greater than what I will, just because there's so much information out there.

Yes, people are going to be able to search and they're going to be able to find blogs and they're going to be able to find peer reviewed articles on what pet food is best. But at the end of the day, the training that goes into veterinary medicine and what our teams are going to need to adopt more and more is the ability to effectively communicate that and to build a relationship with their clients that is founded on trust. I think that trust, it really starts with the way you facilitate every interaction with clients, but in a big part, to David's point, it can't be a race against who can see the most appointments in the day. If that's the foot race that we get into as on a local level, then of course Walmart's going to win out because they've got the well oiled machine to be able to pump out as many appointments as they possibly can.

Mary Schwartz:

I think both of you have hit something really important with what you all were saying about, it is a big change within our industry. Sam, the way your dad learned to practice medicine, grew up doing veterinary medicine, is very different from the way that it needs to be done today. I think sometimes it's hard to strip away that defensiveness of your own expertise, which is something that I have felt. I know we've all scrolled through Facebook and seen a pet parent post and felt that righteous indignation, but how do we strip that away and create an environment where there is psychological safety and patient safety? Where the client feels like they can come in and share, I've been Googling X, Y, or Z, and have it be more of a conversation where they trust the practitioner over Dr. Google?

Sam Schopler:

Yeah, that's what's beautiful about that initial distrust is it's almost like the more distrustful somebody is coming in, the more loyal they'll be when you win them over. I also just want to say it's very, very difficult, changing practice and just being in practice right now, there's so many things happening and the landscape is changing so much that it's a very, very difficult time. I understand that the work is really hard, but I do worry about just trying to compete with all of the different changes that are taking place. When it comes to the ability to create a patient safety culture within the clinic and within the relationship that you have with your client, taking a breather and taking a step to be able to really establish what the wants and needs are of the client for their pet and what are the things that they want to get out of the relationship with their care providers. Really bringing in that more personal communication that can exist within a smaller practice is an in an incredible way to build the foundation of that relationship for that time moving forward.

But it really does have to be a mindset and it has to be a mission of the entire practice. That patient safety being the focal point of what I want to get out of every interaction I have with my clients as a future doctor and establishing on what level is that true of each of my clients, is going to be the best way to honestly ensure that we're doing the things that we need to within that appointment and we're accomplishing the goals that the client wants for the health of their pet. Which gets very complicated, but I think that if we have that as a focal point with our teams, and then with our clients, and as the mission of the clinic, then it does just lend itself towards building that trust early and then making it an effective way of communicating moving forward.

David Liss:

That's a good point, I like that you brought up trust, Sam, and I wanted to reinforce something that you said that I think is super important. I want to make it clear that I do think, and I don't want to sound negative, but I think it's something we have to realize, that people, I think, now are a little bit more inherently distrustful. I don't think it's a negative thing, I think we somehow think that when people question the veterinarian or want to reference Dr. Google, that we take it internally and actually say, they don't trust us anymore, or whatnot. I think the change is that because we're very global as a world now, that they have a lot of choices, so people, clients, pet parents will say, I've got five times as many vet clinics on a street corner that I ever had before. I can Google or YouTube information now, you better up your game when I go to a clinic, you can't tell me that you don't know why something is wrong because the vet down the street will give me a reason.

It's not about them distrusting in a negative way, it's almost about us, as you mentioned, gaining trust back from the client, and almost assuming that we don't have it at the beginning. I think that a new client is a great example, so an old client that has been going to the clinic many years, there's a great way to break their trust, and that comes from changing their experience. Doesn't mean clinics don't change, they have to change and we have to rebuild that, but a new client that walks in, as Sam said from the beginning, especially as a younger millennial, which is like more than half the working population, you want to pull up your phone and get an appointment, you've got a lot of things to do. When you are trying to figure out how to get an appointment, you call the clinic, they put you on hold for 20 minutes, they can't book you, and I'm not blaming anybody, but this is some of the reality.

That trust is immediately going to start to break, and trust is a relationship that builds over time, it's made up of small, incremental steps that lead to trust, and it can be broken a lot faster than it can be built. You're already stringing that along, then you finally get in and there's 50 people in the lobby and they're late for your appointment and the doctor's rushing and it just builds and builds and builds. That's why I think a lot of people have really what they feel are negative experiences at the veterinarian, like the vet killed my dog. The idea is that if trust was built from the very beginning, looking at what do I need as a pet parent and fulfilling that need all the way through, I think that we'd be a lot farther and I think that's what we need to look at going forward, is how do we build trust?

Walmart has trust because of their brand recognition, so I don't think we need to have the local small practice with 1,000 or so clients every year needs to be a Walmart brand, but they need to kind of act like a Walmart brand in the sense that they've got great client service, they've got great veterinarians, they've got great education, they've got great channels to deliver that. So that it competes on the same level with those big boxes, but the great thing is that it's not, and that's another great area to really prioritize.

I think the trust piece is super important and I think we need to really assume that people have so many choices now, price choices, service choices, location choices, that it's not about distrust like, I think you're bad at what you do and you want to you went to vet school to hurt animals. But I think it's saying you got to prove to me that I'm worth it to you because I can go down the street as a client and get service as well, so I think that's where that trust piece comes in. But then once you're starting to build that, you take it and run with it as Sam mentioned, and then you'll have a client for life.

Sam Schopler:

I think that sometimes understanding how nascent a culture we are just in terms of searching the internet. It took 80 years before cars had seat belts, like we don't have a seat belt for the internet right now, so applauding people for engaging with the platform and for taking the incentive to go and search those things, it's sometimes hard to do because the information they may have come to a conclusion on is not medically appropriate. But the fact is that if you were to just take a step back and realize that wow, people are doing independent research, which is something 30 years ago you'd have to pull teeth in order for people to do that kind of research at home.

They would be very scared to enter into a realm that they weren't experts in, but now we have this awesome opportunity to say, you've done a great job initially and here are some awesome sources to go along with what you've been looking at. This is the education, these are the tools that I use to educate myself as I'm continuing to learn as a professional. I think just recognizing that we have to start being that seatbelt in some senses, but hopefully it's not an emergency, maybe it's just the little sign you see above the highway that's like, hey, remember to use peer reviewed at articles.

Mary Schwartz:

Right, people have to want to buckle their seatbelt for it to work. What I wanted to ask was, David, I know that you've worked with a variety of clinics, I know that you've seen a lot of different practices. Knowing that we have this new culture shift towards Googling whatever we need to Google to stay knowledgeable to be the best pet parent that you can, what have you seen clinics do successfully to adapt to this CareFirst model, the higher client engagement, the parody, so to speak?

David Liss:

Yeah, the great thing is that this is going to sound like I'm super smart because I'm going to say all these things, but I didn't come up with these. Social media is a great thing because now as an owner, manager, vet tech, veterinarian, you can stalk other practices and see what they're doing and take great ideas. That's partly this plus the practices that I've worked with, I would say probably one or two of these ideas has been my own, the rest have been theirs. The first one, I think as I mentioned before, was education, if you start following, there are some really good and really funny veterinary education TikToks that are pretty great. Dr. Adam Christman is on TikTok from CBC and Fetch, and he will laugh and make a lot of jokes, but he will talk about vaccine protocols and why you need to bring your dogs poop to the vet and all these different things.

Which are fantastic, so you don't even have to think about producing your own content, you can outsource this and just say, find an influencer that you believe in and link to that and say, here's some great information. Driving the clients to these information sources, a lot of clinics like to build their own libraries, which is great, it's a lot of work. Videos on how to do basic procedures like nail trims and SUBQ injections and how to hold your pet if the doctor needs to examine them, videos on diseases and having the doctors... You can hire a freelance videographer for really not a ton of money and have them come in and have a client or an employee's pet come in and have a really nice video of Dr. Bob in a nice coat with a beautiful background examining a pet and showing them what a great job we do at clinic X, Y, Z.

Building that expertise, again, rebuilding that expertise, because as again, Sam mentioned and I've hit on, is that I think we need to rebuild that expertise and say, we are actually the experts, not Google. But as Sam mentioned too, don't fight it, your clients are already doing it, heck, I do it when I have a little ache in my elbow, I go on Google and I say ache in the elbow and it'll say everything from bone cancer to a little strain. I go, oh, I'll probably take the strain and I don't see my general practitioner all that often. It's already here, so as Sam said, we need to drive them to these areas that they need to do.

I've seen some clinics, which is so counterintuitive, but I've seen them go from a shortened appointment, like a 15 minute or something, back to 30 but charge more. Sounds totally counterintuitive, but a client might pay 20 to 40% more for an exam with 30 minutes with the doctor than they would for $20 exams that are basically five minutes of the doctor's time and possibly, I don't want to say poor care, but lower care in terms of the client's perception. Not that the vet's doing anything wrong, but the client sees 30 seconds of the vet's hands on the animal and wonders, what did I just pay for? I've seen some clients revert to more of that boutique model.

I've seen them staff up and increase and enhance the role of the vet tech... Mary, I know you're a CBT... Throw them in the room after the veterinarian's done to take care of a lot of the client education stuff. I think that's a really underutilized part of what CBTs and any vet tech, vet assistant can do, and it continues to show the client the value they're getting for their exams. I'm sure Sam seems some great stuff too, but those are just some ideas from using technology to speed up the process, as Sam mentioned too, that whole client journey, from the minute they want to find you, using social media and making sure your expertise is forward so that when they find you they know you're expert. Then getting them in as a client, selling them on the service, and using education to augment that and buffer that.

Then the last thing I would say is there's a lot of vet clinics that have started doing client surveys and a little bit beyond just the rating of how the visit went, but what do you need and want from us? Do you want to be on an app? Do you want to have faster appointments, short appointments? Polling your top and bottom 10 clients and doing focus groups and figuring out what your clients need, because you know Walmart's doing that. You know that they're sending out surveys as to how their service was and how fast their checkout was and what other products you want them to offer, so doing the same thing with those clients as well.

Those are just a huge smattering and there's like hundreds more, but those are the kinds of ideas of breaking out of this mold of how we used to do vet med and doing it a little different that I think have really... But they're all aligned with CareFirst, so I've seen them have really, really great results with surveys and changing the flows of the practices and adding technology. The phones go down, it's quieter and more peaceful in the clinic, so those are just some good ideas.

Mary Schwartz:

David, I know that you and I could probably talk about staff utilization all day, we could make probably 10 podcasts about that alone. But I'd love to hear Sam, what your take is on this from the veterinary student perspective, because we in clinic are starting to adapt and starting to learn and at least wanting to. How is vet school preparing you and everyone else around you for entering this environment in which you're going to be treating pets and treating owners? What's the expectation there, and is it more student driven or do you get the sense that schools are starting to adapt and take this approach as well?

Sam Schopler:

I think that when you look at a lot of the newer schools, they are changing up their model of education dramatically. I think at Western, they start in the first week, they've got a role play with a client, before you know anything about vet med, they're just getting you comfortable with communicating with your client. I do think that there's been a big change from a more didactic model towards a more problem solving flipped classroom approach, and I think that's really important because as you were talking, David, it really just reminded me again, of all of these pressures that are on working professionals and on the professionals in training. That you've got to be a great diagnostician, you've got to be a great communicator, you've got to be a great leader, you've got to be a great business owner, there are a lot of things that we aren't explicitly told in vet school, or as a professional, but those pressures exist.

Recognizing what are the things that we can let go of, that we can utilize our techs for, that we can utilize technology for, just to reemphasize what David was talking about. There's such a pressure to do things perfectly as a vet student, I see it all the time in my classmates, that recognizing if you do send out a survey to your clients and they say that they want texting, give them texting. Even if you don't think that's the most appropriate way to practice medicine, at the end of the day, if we're moving the needle on what we're getting our clients to do in terms of the care they're giving for their pets in between visits, that's a huge part of the day to day work that goes unseen in the clinic but that is a really big piece of this building trust and creating a client base that is really built around that more retention model.

In vet school, I would say it's pretty influx, I have loved the education that I've gotten, but we don't get nearly enough time with clients, whether they're role play clients or just communicating with people. I think that what we're seeing more and more is that schools are investing a lot more in the ability to articulate complex thoughts as they come through these data streams of whether it's a telemedicine service or just doing research as an ongoing practitioner. Being able to dialogue that into layman's terms for clients is a huge part of what makes an effective doctor, so I think vet schools are starting to recognize how important that client communication aspect is as it relates to building longevity and trust and ensuring compliance.

Mary Schwartz:

Yeah, learning from the ground up what it's going to be like when you're in that exam room and how to build that lifelong relationship with that client is huge, and it's good to hear that steps are being taken in that direction at least. What do you all perceive would be the biggest challenges or hurdles a clinic would face moving more towards this CareFirst model and way of practicing medicine?

David Liss:

I would have to say it's really their own mindsets that they need to challenge. When you think about, if you were to ask somebody that question, maybe that isn't on the pod and hasn't thought about this deeply like I have, they might say time, staffing, all of those things. I see those as absolutely goals or roadblocks that can 100% be overtaken and conquered, so I have to step back and say, okay, what actually is the thing that would prevent a clinic from doing it. Because there are clinics that have done it, and they all have really the same challenges of trying to find doctors, and not enough technicians, and too many clients, and all these things. It really has to do with their mindset, are they willing to change or are they not willing to change?

Because the world has changed around them, and we talk about COVID and I think that COVID's used a lot as the scapegoat for change. We always joke though that the industry is 20 to 30 years behind the rest of the world, because that's true. Texting was happening 20 years ago in the dental field and forward booking and the use of dental hygienists and the team approach to practicing medicine model. Human medicine has been leveraging registered nurses for a lot longer and have been in EMR for probably 30 years, so there's a lot of stuff that we do, and it's because we're such a small, independent industry, which is being consolidated, but it's still not anywhere near complete. I think that a lot of it is their own mindset and they need to really challenge themselves and say, am I operating in a way that I think is right for my clients and I think is the way that my business should operate, or am I operating in a way that my clients want me to be operating in?

I think that's the huge difference that we have to get over, for many years, it really could be Dr. Jane or Dr. Bob's way of doing things at their practice that would just keep the practice going. We talk about on the pod that commoditization is kind of bad, but I do think that that is the way the world is going, so you almost have to commoditize your independent, private practice. Meaning using the same techniques and tools that successful business chains have done, not becoming a chain, but using social channels, using education, using a team leveraged approach, managing your supply chain, all of those different, branding, and marketing, and expertise, and all of that stuff.

I think that's the really biggest thing is do you... There's nothing wrong with it, but you have to examine, are you operating in a, no offense, but '50s, '60s, '70s, maybe '80s style mindset. You don't have technology, you haven't done any updates to the practice, you could challenge all these other ways that things are being done, you're not offering different holistic or whatever it is. Are you willing to then look at some of these things that many, many clients want, and there's so many resources as to what clients want, AVMA does it and there's a bazillion others. Are you in that or are you really resistant, are you really digging your heels in and saying, as Sam mentioned, I don't think that my clients want texting and I also don't think that texting is a great delivery of care.

If you are in that camp, and I totally get it, I would just encourage you to do two things. One is challenge that mindset, why don't you text and what's the big drawback, is an example, texting, there's all kinds of other things, but as an example. The other one would be talk to somebody who does, call up another owner, manager, clinic that does two-way texting, stalk them online. Obviously they should probably be outside of the competitive landscape, maybe they're in a different state, but go to a website, see somebody that has a Pet Desk, figure out that they do two-way text, and call and say, hey, can I talk to the manager and figure out, did you have a client revolt? I almost guarantee you that 99% of the time that manager's going to say, yeah, nobody cares, they all love texting and they've never had an issue with it, so you really have to challenge where that bias is.

Sam Schopler:

I think, yeah, and with the mindset too, it can be overwhelming to try to imagine where to go with a fresh mindset or how to even figure out what the next steps would be once you do have an open mindset. Because there just is so much happening, David, you just listed like six different strategies that a clinic could employ to improve their client relations or revenue or whatever it is that they're trying to hone in on. I would encourage folks that are in a position to be able to guide their practice, to look to those examples that have done it, just like David said, you can call people up, but there's also models for how to engage with your mindset. If you've never done a SWOT analysis over your business, it's a great thing just to get your team on the same page about what are the things that we all want to be backing when a client asks us about, what's different about your practice than the practice down the road?

What are the things that you want every single client to walk away from your hospital, feeling and thinking, and if you can start to build that into a thought project, then it's not so scary as like we're changing our business practice and our business model. Let's just put it on the table and see what would it look like if we listen to this focus group of clients that said they want an app and they want texting. What would it change, talk to the clinics that have done it before, and engage with some of those tools that can help just formulate what you want your evolved practice to look like in 2022, not in 1970.

Mary Schwartz:

This brings to mind a quote from Dune, which I know I'm outing myself as being nerdy here, but the fear is the mind killer. Fear is the mind killer, you will get in your own head about it and you will think I can't do that, it's too hard, I don't have staff, I don't have time, I don't have revenue, whatever it might be. This is also the solution to all of those problems, so what would you guys say would be the message you want to communicate to somebody who's like, yeah, I think I need to start trying some of these CareFirst solutions, but I don't really know how to take that first step?

David Liss:

Take the first step. I think a lot of us suffer from perfectionism syndrome in veterinary medicine, I think that, Sam, you could counter this but you probably would agree that you probably don't go into wanting to be a veterinarian because you want to mess up, you want to give the wrong drug, you want to make the wrong cut in surgery. No, you want to do the right thing, meaning basically the perfect thing, have the perfect drug, the perfect dose that solves that disease. It's inherent that the level at which we're striving for in veterinary medicine is perfection, because anything less would kill an animal, but however, we're not perfect, we're not robots. I think the one thing that I would tell everybody, the listeners, is first of all, none of this is life threatening.

None of this is life or death, none of this is medicine, that's why business, they say it's not medicine, it's not emotional. Take a step and then I would encourage you not to take a step, meaning we're going to start texting tomorrow, I heard from Mary and Sam on this podcast, we're going to start texting tomorrow. Think of it for, even if you're not a veterinarian on this podcast, if you're a manager or owner work with your medical director or your veterinarian owner, start with step one. What is step one, assessment. What is going on at the practice you want to look through? Do you have upset clients or are you killing it with profit and you couldn't even think twice about making changes, maybe there's no reason to make change.

Step one, then you do a diagnosis, like these are the things that we suffer from, we suffer from old school syndrome or something and you want to work through that. Then you come up with a treatment plan, for the veterinarians on the podcast, I'm sure all of you would love to completely fix the cat's kidney disease today. But you're going to draw the blood, you're going to see the BUN is up and you're going to start something, diet, fluids, whatever it might be. Then what, they come back in a month and you draw more blood and the BUN's a little higher and you try something else. It's an iterative process of trying slowly, what do they say about eating an elephant, one bite at a time, you start with something. Then I would really encourage all of you to find these project management tools like Monday, Asana, there's a bunch of them, where you can roadmap and look at what you want to accomplish in a year, and you do it one day, one month at a time.

For example, if your goal in a year is to start two-way texting, that's great, and you can come up with all the steps that are needed. You can poll your staff, you can find the right platform, you can launch it, you can bait it, whatever. Or if your goal is to completely revamp the practice in a year, that's great too, and you can chunk out all the pieces that you want to look at. This is where I would say this is where you leverage your managers, administrators, whatever you call them, because I think a lot of times veterinarians that are owners that are super involved in the business running of the practice get stuck because they weren't trained how to do business stuff, which makes total sense.

Just like we talked about, they're not thinking about it like a scientific method approach, they don't know what to do, and then they get paralyzed because they're perfectionist, so they can't make the wrong step. They have to step back and say, what would I do if this were a dog in front of me with weird skin symptoms that I don't immediately know the answer to? I can't just jump to giving them Convenia, I have to start with the gums and the ears and the scrape and all these different things to figure out what the heck's going on. Same thing, and business leaders do this all the time, we never leap towards the solution without figuring out what the problem is first.

Sam Schopler:

Everything that you just outlined is perfect and superb, and the only color that I would add to it is that there are very few practices that I've shadowed in or worked in, in which I feel as though the whole team understands the mission of the clinic. If there is an opportunity to really dive into exactly what we want our ideal customer, our ideal client to look like, especially if we go back to the beginning of this conversation when we're talking about these big box stores, the commoditization of pets, there's a segment of clients that are going to opt for that experience. That's going to take away some clients from some clinics, sure, it's going to be hopefully a negligible amount. But in the same way, we talked about how there's this segment of clients that are moving towards understanding full personhood of their pets and making these very emotional and raw decisions about their pets, thinking deeply about how to care for them.

That offers, then, an opportunity for us to welcome those clients into our practice, but each clinic has its own special sauce of care. Building on that special sauce of care is hugely important for understanding the customer journey and the customer mindset and putting yourself in the shoes of your clients in order to make a more effective effort in a seamless building of trust through their interactions with your technology, with your team, and with your clinic. Looking at what are the things that make us special and unique and what are our ideal clients in terms of what they want to get out of their relationship with their vet clinic and with their teams within the vet clinic, that then can be the foundation by which you go through those exercises that David was talking about.

You start to build a methodology that every single person in the clinic can point to and say, this is what we are behind at this clinic, and that's why we do these things. That's why we don't allow our clients to do these things, that's why we opt for this medication. It can all roll back into what your beliefs are in how you want that patient care to look so that we can start working towards a CareFirst collaborative approach.

Mary Schwartz:

You got to have that unifying North Star. I think this discussion has been really awesome, I really enjoy hearing both of your in input on all of these issues, you guys have a a lot of great things to say and a lot of great experience. Is there anything else that we haven't touched on today that you guys want to share?

Sam Schopler:

Put me on the spot, no, I think just continuing to breathe through these changes, there are an awful lot of caring pet parents out there that want the type of relationship that you offer at your practice. Just understanding that the landscape is changing, but to David's point, none of the decisions that we're talking about here are life or death. Just recognizing that there's a huge community of support out there in making these decisions, in implementing these decisions, and following through with these decisions. That ranges from social media groups, that ranges to the teams I know at companies like Pet Desk, and just reaching out to a clinic that you saw implement something, I'm sure that they're going to give you the time to say, this is what worked for us and this is what didn't. But know that you're not alone and that there are a lot of people that are eager to help make this transition easy, myself included. Just making sure that we recognize that it is a bit of a tumultuous time in the industry and even in the country, so there are a lot of people there to support you.

David Liss:

That's a great point, I'll kind of echo that as well and say that it's very easy, if you were listening to this podcast and you don't have any of the stuff we chatted about or maybe don't have all of the stuff we chatted about, we are so hard on ourselves internally. I can totally see some of you all with imposter syndrome, getting off the podcast and saying, oh my god, we have to start all this stuff tomorrow, as a kind of reaction to a little bit of a deep voice saying we're not good enough because we don't have X, Y, and Z. No vet clinic is perfect, everybody is struggling with all of these challenges, just because I said a clinic put in two-way text messaging doesn't mean I solved all of their crises or made them find a bunch of technicians.

It's about really having this big, as Sam mentioned, mission vision for your practice, getting the team aligned behind it, and then figuring out what tools solve that. For example, if the mission is CareFirst or some other moniker that you want to be your rally or your battle cry at your practice, and you try to figure out a way to implement that. Texting, all the other stuff that we talked about today, are really our tools to get that done, so that's how to approach it. Versus we should do texting because we have to be on the train, it really should be we're not providing CareFirst because we could be if we were doing X, Y, Z, that's the way to think about it. In that way, you're always really more glass half full than glass half empty.

This isn't meant to say you're wrong or you're not doing something wrong because you have two-way texting. As I mentioned, if you have fat margins and you have a successful practice and great staff and clients that you're booked out six weeks, forget texting, nobody cares about that at your practice. But if you have a clinic that is struggling to build up clients, or you have a lot of negative reviews, or whatever it might be, you probably, as Mary said, you've got misaligned from your North Star, so find your North Star again, and then utilize the tools to get you back on track.

Mary Schwartz:

In the spirit of building that community and taking these first steps, how can our listeners follow you guys on social media or in your preferred way that you would be followed?

Sam Schopler:

I'm pretty social media-less on purpose, but I am at the NC State College of Veterinary Medicine, I'm on the board there with the Veterinary Business Management Association. We actually will be having a conference, the Wolfpack Leadership Conference, sometime in 2023, early 2023, so if you're a local practitioner or if you're a practice manager, anybody who's interested in learning about this synergy between the student world and the vet industry, that'll be a great thing to look towards. But other than that, you can't find me.

David Liss:

What's really funny is I'm also the same as Sam, I don't use a lot of social media, partly, I just personally I don't, so for me it would just be email, [email protected] My Facebook is kind of locked down, I don't have an Instagram, so it sounds crazy because it's like I'm not practicing what I'm preaching, but it's more of a personal decision. If I owned a business I would probably have the business out there, but feel free to email me, and again, as Sam mentioned, Pet Desk is such an amazing resource for you all.

Sam Schopler:

Yeah, I'll piggyback on that, I do have a LinkedIn, that is social media, so feel free to find me there. I do a fair amount of consulting and would be happy to chat with anybody who has questions, so find me on LinkedIn. Then my email is [email protected], so feel free to hit me up there too.

Mary Schwartz:

Share with us what your favorite Dr. Google story is.

David Liss:

My cousin emailed me a few days ago and said, hey, how's it going, hope all's well, can you take a look at this, and she sent a link. Man, I was already pretty bristly because the link was something like dogfoodexpose.com or something, and I thought, oh my god, even my family is on these trains. I watched this link and it was a veterinarian, I don't know him or his work, I can't disparage it, but he was claiming that dog food, there's all these issues with it. I just responded back, because I'm not a dog food expert, but I just said, look, I don't know this person's work, we do have board certified veterinary nutritionists in the field that consult with dog food companies. Dog food companies, even the large ones are regulated at some level by the government, so if you have questions about your dog's diet, please just talk to your veterinarian.

She just responded, thank you so much, but that's not the first time I was sent a link once about the complications of vaccines and Lyme disease will give dogs cancer and all this stuff. I'm not a veterinarian, to make it super clear, and I obviously tell them that, but I'm sure that Sam, when he becomes Dr. Schopler, is going to get a lot of this, I read online that if you give my dog this vaccine under his skin, he can die of bone tumors. We all have to face that, so that was my story, I thought it was just pretty funny, she's a lovely human.

The click bait type of stuff, I just saw it and I immediately knew this was going to get me into some trouble. I don't know that veterinarian's work, but I abide by the American College of Veterinarian Nutrition and the AFCO guidelines and all the stuff that is surrounded pet food. I think that most pet food companies... If you're feeding them ALPO and the dog's not really have any issues from the ALPO, the ALPO's not killing your dog, it's doing okay, so that's kind of the way that I responded to her.

Sam Schopler:

I guess all of my Dr. Google stories are going to happen in a few years when I'm at practice, I don't have any off the top of my mind. I think I'll just say that it's pretty eye opening to me going through the education to become a veterinarian, just how singularly focused a lot of people's expertise is around different systems of organisms and how those may have evolved over time in order to accommodate different aspects of the world. I mean that in the broadest sense, because I even have a family friend who's an MD who I was talking to about what we were learning in school and I was talking about diabetes and I was talking about all these different diseases. She was like, wait a minute, dogs get diabetes, like what, cats get diabetes? I was like, yeah, definitely, they've got kidneys too actually.

I think that is on the most extreme level just an example of how people don't understand the full picture, so I remember hearing about a person who brought their cat in, who was on an all vegan diet, as an obligate carnivore. Those are the things where you get into this wormhole, some people... It's tough, so patience, patience.

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